侧侧脊柱动脉动脉瘤导致脑下下出血:文献综述和案例报告
Yoo Sung Jeon1, Jeong Jin Park2, Young Il Chun1
1Department of Neurosurgery, Konkuk University Medical Center, Seoul 05030, Republic of Korea.
Journal of clinical medicine
|August 29, 2024
概括
破裂的侧脊动脉 (LSA) 动脉瘤导致脑下关节出血 (SAH) 是罕见的,但具有挑战性. 诊断需要先进的成像,治疗必须是个性化的,结合手术和内血管方法,以获得更好的结果.
科学领域:
- 神经科学是一个神经科学.
- 血管外科 血管外科
- 放射学 放射学是一门学科.
背景情况:
- 破裂的侧脊动脉 (LSA) 动脉瘤导致下大脑关节出血 (SAH) 是非常罕见的.
- 由于复杂的解剖学,LSA动脉瘤存在独特的诊断和治疗挑战,与常见的大脑动脉瘤不同.
研究的目的:
- 分析临床表现,诊断挑战,治疗策略和侧侧脊髓动脉动脉瘤的结果.
- 突出了解LSA血管解剖学的重要性,以改善诊断和治疗.
主要方法:
- 对导致SAH的LSA动脉瘤病例报告的文献综述.
- 分析了11例病例 (10例来自文献,1例来自现实病例),包括临床数据,成像发现和治疗结果.
主要成果:
- 在11例LSA动脉瘤中,只有2例最初通过CT血管造影检测到;脑膜输血血管造影更有效 (5例).
- 七名患者有相关的动脉狭窄或闭塞. 治疗包括微手术剪切 (7名患者) 和内血管方法 (3名患者).
- 并发症包括PICA心脏病发作和体内血液瘤.
结论:
- 侧侧脊髓动脉动脉瘤应在后SAH的差异诊断中考虑.
- 准确的诊断可能需要重复成像,治疗应该是个性化的,使用手术和内血管技术.
- 了解LSA血管解剖和附带途径对于提高诊断准确性和治疗成功至关重要.
相关概念视频
Local Anesthetics: Clinical Application as Spinal Anesthesia
2.0K
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
2.0K
The Arch of Aorta
2.2K
The coronary arteries, originating from the ascending aorta, bifurcate from two sinuses located within the ascending aorta. Positioned just above the aortic semilunar valve, these sinuses house essential aortic baroreceptors and chemoreceptors, crucial for maintaining cardiac function. The left coronary artery and the right coronary artery branch off from the left posterior and anterior aortic sinuses, respectively.
Encircling the heart, the coronary arteries form a ring-like structure before...
Encircling the heart, the coronary arteries form a ring-like structure before...
2.2K
Aneurysm II: Clinical Manifestations and Diagnostic Studies
588
Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
588
Hemorrhagic Stroke l: Introduction
20
A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...
20
Hemorrhagic Stroke ll: Pathophysiology
28
A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
28
Secondary Spinal Cord Injury llI: Pathophysiology
51
Early Ischemia and Ionic ImbalanceWithin minutes of spinal cord injury, a secondary cascade begins, progressing over hours to weeks. Vascular damage reduces blood flow, causing ischemia and mitochondrial dysfunction. ATP depletion leads to ion pump failure, membrane depolarization, sodium influx, potassium efflux, and water accumulation, resulting in cellular swelling. Increased intracellular calcium further disrupts mitochondria and accelerates cellular injury.Excitotoxicity and Neuronal...
51


