内血管治疗真菌的内 Carotid 动脉动脉瘤
Naoki Irizato1, Tomohiko Ozaki1, Hajime Nakamura1
1Department of Neurosurgery, The University of Osaka Graduate School of Medicine, Suita, JPN.
Cureus
|September 10, 2025
概括
菌类脑动脉瘤很罕见,但致命. 这一案例表明,通过使用母动脉封闭,成功治疗由阿斯伯吉路斯鼻炎引起的破裂的内动脉动脉瘤.
科学领域:
- 神经学 神经学
- 传染性疾病 传染性疾病
- 血管外科 血管外科
背景情况:
- 由于真菌性鼻炎,真菌性脑动脉瘤,特别是由于真菌性鼻炎导致的内动脉 (ICA) 洞穴段,很少见,死亡率很高.
- 直接的真菌入侵构成了重大威胁,往往导致致命的结果.
研究的目的:
- 报告一个由Aspergillus鼻炎引起的第二次菌ICA动脉瘤破裂的病例.
- 为了突出这一罕见疾病的成功管理,使用父动脉封闭 (PAO).
- 强调早期诊断干预和治疗策略的重要性.
主要方法:
- 一个80岁妇女的案例研究,她有神经麻和面部疼痛的症状.
- 包括MRI和血管造影在内的诊断成像揭示了ICA洞腔段的真菌动脉瘤,其中包括状鼻.
- 通过鼻的聚合酶链反应确认了Aspergillus fumigatus的存在.
- 治疗包括在动脉瘤破裂后使用双导管技术出现母动脉封闭.
主要成果:
- 这位患者出现了阴和多重头骨神经麻 (III,IV,VI).
- 尽管初始的抗真菌治疗和鼻灌,动脉瘤扩大,随后破裂,导致表和休克.
- 新出现的PAO成功地进行了,保持了附带循环,并没有导致新的神经系统缺陷,只有残留的眼运动.
结论:
- 早期气球闭塞检测对于管理真菌ICA动脉瘤至关重要,因为它们的破裂风险很高.
- 父母动脉封闭,特别是用双导管技术,可以是一个有效的治疗方法,最大限度地减少缺血并发症,并保持附带流.
- 这一案例强调了PAO在危及生命的真菌动脉瘤破裂中的成功应用.
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