医源性假性动脉瘤术后：远离邪恶。病例报告及文献复习

IF 1.5 4区医学 Q4 CLINICAL NEUROLOGY

Neurochirurgie Pub Date : 2025-05-16 DOI:10.1016/j.neuchi.2025.101680

Anis Mansourt, Adrien May, Francesco Travaglini, Henry Dufour, Thomas Graillon, Kaissar Farah

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引用次数: 0

摘要

颅内假性动脉瘤是罕见的，占所有颅内动脉瘤的不到2%。它们最常发生在头部损伤后，但也可能由神经外科或耳鼻喉科手术期间的医源性动脉损伤引起。对于此类动脉瘤的治疗和监测，目前还没有明确的指导方针。方法本文报告2例医源性假性动脉瘤的保守治疗，并对颅内医源性假性动脉瘤的治疗及预后进行综述。病例报告及结果第一例经颅入路，第二例经蝶窦入路，均经保守治疗，密切随访，动脉瘤自行愈合。结论血管内治疗或手术夹闭是治疗医源性假性动脉瘤的两种有效方法，在风险合理且可行的情况下应优先选择。相比之下，对于小的假性动脉瘤，风险大且手术复杂，保守治疗并密切随访似乎是一个有价值的选择。

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Iatrogenic pseudoaneurysm after surgery: Stay away from the evil. Case report and review of the literature

Background

Intracranial pseudoaneurysms are rare and account for less than 2% of all intracranial aneurysms. They most frequently occur after head injury, but they also can be caused by iatrogenic arterial injury during neurosurgical or ENT procedures. No clear guidelines are established concerning the treatment and surveillance of such aneurysms.

Methods

In this article, we present 2 cases of iatrogenic pseudoaneurysms treated conservatively and we propose a review of literature of the management and outcome of intracranial iatrogenic pseudoaneurysms.

Case report and results

The first case is one during a transcranial approach and the second one during a transsphenoidal approach, that were both conservatively treated with a close follow-up and a spontaneous healing of the aneurysm.

Conclusion

Endovascular treatment or surgical clipping are 2 valid therapeutic options in iatrogenic pseudoaneurysms, which should be preferred when feasible with a reasonable risk. In contrast, in case of a small pseudoaneurysm, important risk and complex procedures, conservative treatment with a close follow-up appears to be a valuable alternative.

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来源期刊

Neurochirurgie 医学-临床神经学

CiteScore

2.70

自引率

6.20%

发文量

100

审稿时长

29 days

期刊介绍： Neurochirurgie publishes articles on treatment, teaching and research, neurosurgery training and the professional aspects of our discipline, and also the history and progress of neurosurgery. It focuses on pathologies of the head, spine and central and peripheral nervous systems and their vascularization. All aspects of the specialty are dealt with: trauma, tumor, degenerative disease, infection, vascular pathology, and radiosurgery, and pediatrics. Transversal studies are also welcome: neuroanatomy, neurophysiology, neurology, neuropediatrics, psychiatry, neuropsychology, physical medicine and neurologic rehabilitation, neuro-anesthesia, neurologic intensive care, neuroradiology, functional exploration, neuropathology, neuro-ophthalmology, otoneurology, maxillofacial surgery, neuro-endocrinology and spine surgery. Technical and methodological aspects are also taken onboard: diagnostic and therapeutic techniques, methods for assessing results, epidemiology, surgical, interventional and radiological techniques, simulations and pathophysiological hypotheses, and educational tools. The editorial board may refuse submissions that fail to meet the journal''s aims and scope; such studies will not be peer-reviewed, and the editor in chief will promptly inform the corresponding author, so as not to delay submission to a more suitable journal. With a view to attracting an international audience of both readers and writers, Neurochirurgie especially welcomes articles in English, and gives priority to original studies. Other kinds of article - reviews, case reports, technical notes and meta-analyses - are equally published. Every year, a special edition is dedicated to the topic selected by the French Society of Neurosurgery for its annual report.