因双侧结构夹层导致巨大基底动脉尖动脉瘤和基底动脉自发性闭塞：病例报告
Spontaneous occlusion of a giant basilar tip aneurysm and a basilar artery due to the dissection of both structures: case report.
作者信息
Maeda K, Usui M, Tsutsumi K, Iijima A
机构信息
Department of Neurosurgery, Aizu Central Hospital, Fukushima, Japan.
出版信息
Surg Neurol. 1997 Dec;48(6):606-9. doi: 10.1016/s0090-3019(96)00544-7.
BACKGROUND
Spontaneous occlusion of a giant aneurysm with its parent artery is relatively rare. Complete occlusion of a giant aneurysm at the basilar bifurcation and a basilar artery due to the dissection of the basilar artery has never been reported.
CASE DESCRIPTION
This 62-year-old man presented with left hemiparesis and right oculomotor palsy. Radiographic study showed a giant aneurysm at the basilar artery bifurcation with hemorrhage in its wall and an ischemic area in the right midbrain. Subsequent study revealed that thrombosis of the aneurysm rapidly progressed and that the parent basilar artery caused the dissection. Finally the giant aneurysm and the basilar artery were completely thrombosed.
CONCLUSION
The dissection was considered to occur in the aneurysm wall first by the hemorrhage in it and progress proximally along the basilar artery. Intramural hemorrhage in the wall of a giant aneurysm can be a cause of dissection of its parent artery. This seems to be one of the mechanisms by which a giant aneurysm and its parent artery are spontaneously thrombosed.
背景
巨大动脉瘤与其供血动脉发生自发性闭塞相对罕见。因基底动脉夹层导致基底动脉分叉处巨大动脉瘤及基底动脉完全闭塞的情况从未有过报道。
病例描述
该62岁男性患者出现左侧偏瘫和右侧动眼神经麻痹。影像学检查显示基底动脉分叉处有一巨大动脉瘤，瘤壁有出血，右侧中脑有缺血区。后续检查发现动脉瘤内血栓形成迅速进展，且其供血基底动脉发生了夹层。最终，巨大动脉瘤和基底动脉完全血栓形成。
结论
认为夹层首先在动脉瘤壁内因瘤内出血而发生，并沿基底动脉向近端发展。巨大动脉瘤壁内的壁内出血可能是其供血动脉夹层的原因。这似乎是巨大动脉瘤及其供血动脉发生自发性血栓形成的机制之一。
Zotero 插件