血管造影阴性的弥漫性蛛网膜下腔出血血管壁成像显示扁桃体状动脉瘤破裂。

IF 1.2 Q4 CLINICAL NEUROLOGY
Neurointervention Pub Date : 2024-07-01 Epub Date: 2024-06-05 DOI:10.5469/neuroint.2024.00185
Huy Quang Phi, Suehyb Ghazi Alkhatib, Scott Bruce Raymond, Omar Aftab Choudhri, Jae Won Song
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引用次数: 0

摘要

一名患者因急性头痛发病,随后昏迷不醒。神经系统检查显示左侧肌阵挛抽搐和右侧弛缓性偏瘫。非对比计算机断层扫描显示弥漫性蛛网膜下腔出血(SAH)伴急性脑积水。最初的数字减影血管造影(DSA)显示没有SAH的罪魁祸首。初次就诊后第7天再次进行数字减影血管造影检查,怀疑左侧颈内动脉眼段和左侧扁桃体动脉(LSA)动脉瘤。鉴于存在多个潜在的罪魁祸首动脉瘤,患者接受了磁共振血管壁成像(VWI)检查。左侧 LSA 动脉瘤穹顶周围的血管壁增强提示动脉瘤破裂,这为手术切除提供了便利。LSA 动脉瘤极为罕见,治疗难度很大。考虑到相关的高发病率,快速诊断对于指导治疗至关重要。在血管造影阴性的 SAH 患者中,VWI 可能是检测动脉瘤破裂的重要工具。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Vessel Wall Imaging in Angiogram-Negative Diffuse Subarachnoid Hemorrhage Reveals a Ruptured Lenticulostriate Aneurysm.

A patient presented with acute onset headache and subsequent unconsciousness. The neurologic exam showed left-sided myoclonic jerking and right flaccid hemiparalysis. Noncontrast computed tomography revealed diffuse subarachnoid hemorrhage (SAH) with acute hydrocephalus. Initial digital subtraction angiography (DSA) showed no culprit source for SAH. Repeat DSA on day 7 after initial presentation raised suspicion for left internal carotid artery ophthalmic segment and left lateral lenticulostriate artery (LSA) aneurysms. A magnetic resonance vessel wall imaging (VWI) exam was performed given the presence of multiple potential culprit aneurysms. Vessel wall enhancement around the dome of the left LSA aneurysm suggested rupture, which then facilitated treatment with surgical clipping. LSA aneurysms are exceedingly rare and challenging to treat. Given the associated high degree of morbidity, expedient diagnosis is critical to direct management. VWI could be a valuable tool for detecting ruptured aneurysms in the setting of angiogram-negative SAH.

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来源期刊
CiteScore
1.80
自引率
0.00%
发文量
34
审稿时长
12 weeks
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