大脑前动脉巨大蛇形动脉瘤1例报告并文献复习

Giant serpentine aneurysm of anterior cerebral artery:A case report and literature review

目的结合文献复习完善对大脑前动脉巨大蛇形动脉瘤(GSA)的认识,提高该病的诊治水平。方法回顾性分析1例GSA病人的临床资料,予开颅动脉瘤夹闭切除术。总结该病例特点并结合文献进行分析讨论。结果术后病理显示:动脉瘤内血栓形成。术后3个月随访预后良好,改良Rankin评分为0分。DSA复查:右侧颈内动脉未见明显血管狭窄及动脉瘤,右侧大脑前动脉近段1支被动脉瘤夹夹闭,静脉引流通畅。结论以间断头痛起病考虑肿瘤卒中的病人,结合影像学特征,应认识到存在GSA的可能;完善的术前检查及颅内血管代偿情况评估对选择GSA手术方式非常必要。

Objective Combined with literature review to improve the understanding, diagnosis and treatment of giant serpentine aneurysm(GSA) of the anterior cerebral artery. Methods General clinical data and imaging examination of 1 patient with GSA were analyzed retrospectively, and craniotomy for aneurysm clipping was performed,the characteristics of the case were summarized and the relevant literature was reviewed. Results Postoperative pathology showed thrombus formation in the aneurysm. At 3 months of follow-up, the outcome was good, and the improved Rankin score was 0. DSA review showed: no obvious vascular stenosis or aneurysm was found in the right internal carotid artery, a proximal part of the right anterior cerebral artery clipped, and the venous drainage unobstructed. Conclusions The possibility of GSA should be recognized in patients with stroke with intermittent headache,combined with imaging characteristics. Perfect preoperative examination and evaluation of intracranial vascular compensation are very necessary for the selection of GSA surgery.