Funakoshi T, Tsuchiya J, Sakai N, Yamada H, Sakata K
No Shinkei Geka. 1976 Apr;4(4):405-10.
In 33 year-old man an aneurysm of a pheripheral branch of the right middle cerebral artery was disclosed by angiography 8 days after extirpation of a parietotemporal brain abscess. The aneurysm was absent in the preoperative angiogram. Since the site of the aneutysm coincided with the operative field, it is sure that the etiology of the aneurysm was related to operative trauma and/or arteritis. Although inflammatory or mycotic factor could not be excluded from its etiology, it seems reasonable that traumatic factor was major one. The aneurysm was found to have disappeared eventually in the angiogram made on 372th postoperative day. Traumatic aneurysms arising from peripheral branches of the intracranial arteries are very rare. The first case was reported by Krauland in 1949. We collected 32 such cases from the literature. Of the 33 cases including the present one, 5 are iatrogenic. In more than half of the 33 cases, aneurysms were formed within 14 days following head injury. Posttraumatic delayed hemorrhage was found in 15 cases, the hemorrhage occurring within one month following injury in 12 cases. Of 31 cases with known prognosis, 11 died, 6 of them dying of delayed hemorrhage. Aneurysm operation was performed in 21 cases and 15 of them survived. In the present case, aneurysm luckily healed spontaneously. There are two cases including the present one, of spontaneous healing in the 33 cases. We believe surgical treatment is one of choice whenever possible.
在一名33岁男性患者中，颞顶脑脓肿切除术后8天，血管造影显示右侧大脑中动脉外周分支存在一个动脉瘤。术前血管造影未发现该动脉瘤。由于动脉瘤的位置与手术区域相符，因此可以确定动脉瘤的病因与手术创伤和/或动脉炎有关。虽然不能排除炎症或霉菌性因素，但创伤因素似乎是主要原因。在术后第372天的血管造影中发现该动脉瘤最终消失。颅内动脉外周分支产生的创伤性动脉瘤非常罕见。首例病例由克劳兰德于1949年报道。我们从文献中收集了32例此类病例。包括本病例在内的33例中，5例为医源性。在33例中的半数以上病例中，动脉瘤在头部受伤后14天内形成。15例发现有创伤后延迟性出血，其中12例在受伤后1个月内出血。在31例已知预后的病例中，11例死亡，其中6例死于延迟性出血。21例进行了动脉瘤手术，其中15例存活。在本病例中，动脉瘤幸运地自行愈合。在这33例病例中，包括本病例在内有2例自发愈合。我们认为只要有可能，手术治疗是一种选择。
