烟雾病伴发动脉瘤(附22例报道)

Moya Moya disease complicated by aneurism formation(with 22 cases report)

目的 探讨烟雾病伴发动脉瘤的发病情况及其临床意义。方法 回顾性总结我院 12年遇到的 2 5 8例烟雾病病人 ,其中 2 2例伴发脑动脉瘤 ,临床发病为急性卒中型 12例 ,缓慢起病者 10例 ,全部病例均经全脑血管造影证实。结果 伴发的动脉瘤为外周动脉型 18例 ,占 81.81% ,其中载瘤动脉为穿支动脉者 6例 ,豆纹动脉者 7例 ,后脉络膜动脉 4例。大动脉型 4例 ,占 18.19%。结论 烟雾病伴发动脉瘤破裂可导致颅内出血 ,CT可查明血肿部位而DSA检查常可确诊 ;大动脉型者可用血管内栓塞治疗 ,外周动脉型者治疗目前尚无一理想方法 。

Objective To find out the occurrence and clinical significance of Moya Moya disease complicated by aneurism formation. Methods A group of 258 cases of Moya Moya disease within past 12 years in our daily work were reviewed. 22 cases of them were complicated with aneurism formation manifested clinically by acute stroke in 12 cases, slow onset of the disease in 10 cases, and all the cases were confirmed via cerebral angiography. Results Among the complicated aneurisms, 18 were peripheral artery type (81.8%), in which 6 patients originated from perforating arteries, 7 from lenticulostriate arteries, 4 from posterior choroidal arteries; the other 4 cases were large artery type (18.19%). Conclusions Moya Moya disease complicated with aneurism formation might result in intracranial haemorrage. CT was used to locate the haematoma while DSA was used to verify the diagnosis. For large artery type aneurism, it can be treated with intra vascular embolization, while peripheral artery type aneurism, yet no appropriate method is now available and still under further study.