前脑动脉形动脉瘤归因于双边持久原始嗅觉动脉:病例报告
Miku Tsuruya1, Kenta Koketsu1, Kyongsong Kim1
1Department of Neurological Surgery, Chiba Hokuso Hospital, Nippon Medical School, Inzai, Chiba, Japan.
NMC case report journal
|January 24, 2025
概括
持久原始嗅觉动脉 (PPOA) 是罕见的,但可以发展动脉瘤. 对双边PPOA状动脉瘤的一种成功的手术方法涉及陷和放射性动脉移植绕道手术.
科学领域:
- 神经学 神经学
- 神经外科 神经外科
- 血管外科 血管外科
背景情况:
- 持久原始嗅觉动脉 (PPOA) 是前脑动脉 (ACA) 的罕见解剖变体.
- 动脉瘤,通常是状,可以在PPOA中发展,最常见的是单边.
- 双边PPOA非常罕见,相关动脉瘤带来了独特的管理挑战.
研究的目的:
- 在患有双边持久原始嗅觉动脉 (PPOA) 的患者中报告一种罕见的状动脉瘤病例.
- 用捕捉和绕道技术的组合来描述这种复杂动脉瘤的成功手术管理.
- 突出放射性动脉移植帽绕道在管理PPOA动脉瘤中的有效性.
主要方法:
- 通过脑磁共振成像 (MRI) 和脑血管造影,诊断得到证实,揭示了双边PPOA和左侧状动脉瘤,带有"珍珠和弦"标志.
- 手术策略包括捕获动脉瘤并使用放射性动脉 (RA) 移植进行帽子绕道.
- 绕道将左侧表面动脉连接到左侧PPOA的远端部分,创建一个A3-A3绕道.
主要成果:
- 这位患者在近道左侧PPOA出现了状动脉瘤,在例行健康检查中检测到.
- 手术后的康复没有任何事件,手术后30个月没有观察到神经学缺陷.
- 磁共振血管造影 (MRA) 证实动脉瘤没有复发.
结论:
- 双边PPOA中的动脉瘤形成是一种罕见但重要的临床实体.
- 结合动脉瘤捕获与放射性动脉移植帽绕道是一种可行的和有效的手术选择,用于管理复杂的PPOA动脉瘤.
- 这种方法成功地治疗了动脉瘤,同时保持了流动,避免了对应方PPOA的过度压力.
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