Marshman L A, Ward P J, Walter P H, Dossetor R S
Department of Neurosurgery, Hurstwood Park Neurological Centre, Princess Royal Hospital, West Sussex, England.
Neurosurgery. 1998 Dec;43(6):1445-8; discussion 1448-9. doi: 10.1097/00006123-199812000-00107.
Infundibula (IFs) are funnel-shaped symmetrical enlargements that occur at the origins of cerebral arteries and are apparent on 7 to 25% of otherwise normal angiograms. They are frequently considered as normal anatomic variants of no pathogenic significance.
We report the case of a ruptured posterior communicating artery aneurysm that had developed at the site of a previously known IF in a 49-year-old hypertensive woman. She had a poor conscious level at admission, with widespread subarachnoid hemorrhage and obstructive hydrocephalus.
The patient was immediately ventilated, and an external ventricular drain was inserted. The aneurysm was successfully clipped; however, secondary hemorrhage occurred both before and during craniotomy. She developed marked hypernatremia and subsequently died.
This is the 11th case of IF-to-aneurysm progression reported. It suggests that in certain cases, serial investigations may be indicated with IFs to detect aneurysm formation and preempt rupture.
漏斗部（IFs）是在脑动脉起始处出现的漏斗状对称性增宽，在7%至25%的正常血管造影中可见。它们常被视为无致病意义的正常解剖变异。
我们报告一例49岁高血压女性，其破裂的后交通动脉瘤发生在先前已知的漏斗部部位。入院时她意识水平差，伴有广泛蛛网膜下腔出血和梗阻性脑积水。
患者立即接受通气，并插入了外部脑室引流管。动脉瘤成功夹闭；然而，开颅手术前和手术期间均发生了继发性出血。她出现明显的高钠血症，随后死亡。
这是第11例报告的从漏斗部发展为动脉瘤的病例。这表明在某些情况下，可能需要对漏斗部进行系列检查以检测动脉瘤形成并预防破裂。
