颈内动脉clinoid段未破裂的小型脑动脉瘤自发消失:病例报告和文献综述。

Surgical neurology international Pub Date : 2024-08-23 eCollection Date: 2024-01-01 DOI:10.25259/SNI_493_2024
Koki Onodera, Kuya Azekami, Noriyuki Yahagi, Ryutaro Kimura, Ryuta Kajimoto, Masataka Yoshimura, Shinya Kohyama
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引用次数: 0

摘要

背景:据报道,巨大动脉瘤患者会出现不同程度的血栓形成。然而,未破裂的小动脉瘤很少会自发消退。在此,我们报告了一例左侧颈内动脉(ICA)clinoid段(C3)未破裂的小动脉瘤病例,随访1年后,该动脉瘤几乎完全闭塞:一名 66 岁的妇女左侧脑室周围出现蛛网膜下腔出血。入院时进行的脑血管造影检查未发现出血迹象。随后在第12天进行的脑血管造影显示,小脑上动脉(SCA)的一个分支上有一个剥离性动脉瘤。术后过程顺利,患者于第22天出院,改良Rankin量表评分为1分。1年的随访脑血管造影显示,SCA分支上的剥离动脉瘤仍处于闭塞状态。值得注意的是,蛛网膜下腔出血发生时左侧 ICA 的clinoid 段(C3)有一个 2 毫米的未破裂小动脉瘤,未经干预几乎完全闭塞。动脉瘤自发消退一年后,磁共振血管造影显示没有明显复发:本病例突出表明,即使是未破裂的小动脉瘤也可能发生自发性闭塞。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Spontaneous disappearance of a small unruptured cerebral aneurysm in the clinoid segment of the internal carotid artery: A case report and literature review.

Background: Various degrees of thrombosis have been reported in patients with giant aneurysms. However, small, unruptured aneurysms rarely resolve spontaneously. Herein, we report a case of a small unruptured aneurysm in the clinoid segment (C3) of the left internal carotid artery (ICA) that showed almost complete occlusion at the 1-year follow-up.

Case description: A 66-year-old woman developed a subarachnoid hemorrhage on the left side of the perimesencephalic cistern. Cerebral angiography performed on admission revealed no evidence of hemorrhage. Subsequent cerebral angiography on day 12 revealed a dissecting aneurysm on a branch of the superior cerebellar artery (SCA), and the patient underwent parental artery occlusion with 25% n-butyl-2-cyanoacrylate. The postoperative course was uneventful, and the patient was discharged on day 22 with a modified Rankin Scale score of 1. The 1 year follow-up cerebral angiogram demonstrated that the dissecting aneurysm in the SCA branch remained occluded. Notably, a small 2-mm unruptured aneurysm in the clinoid segment (C3) of the left ICA, which was present at the onset of subarachnoid hemorrhage, was almost completely occluded without intervention. Magnetic resonance angiography 1 year after spontaneous resolution of the aneurysm showed no apparent recurrence.

Conclusion: This case highlights that even small, unruptured aneurysms can develop spontaneous occlusions.

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