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首页> 外文期刊>The Canadian Journal of Neurological Sciences: le Journal Canadien des Sciences Neurologiques >Non-atherosclerotic fusiform cerebral aneurysms.
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Non-atherosclerotic fusiform cerebral aneurysms.

机译：非动脉粥样硬化梭状脑动脉瘤。

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BACKGROUND: Fusiform cerebral aneurysms are dilatations of the entire circumference of a segment of cerebral artery, usually considered due to atherosclerosis in adults. They are relatively thick-walled and elongated, causing neural compression or ischemia when discovered. We have noted a subset of fusiform cerebral aneurysms that vary from this common description. PATIENTS: Out of a series of 472 intracranial aneurysms treated over 11 years, 11 patients between the ages 16 and 67 years (mean age 37) were identified who had discrete fusiform aneurysms unassociated with generalized cerebral atherosclerosis, connective tissue disorder or inflammation. Three presented with hemorrhage, six with neural compression by the aneurysm and two were discovered incidentally. RESULTS: Nine aneurysms were located in the posterior circulation, the other two in the intracranial carotid artery. Their mean length and width were 16.3 and 11 mm, respectively. Three aneurysms contained thrombus. The eight aneurysms that were exposed surgically were partly or substantially thin-walled with normal appearing parent arteries. Eight were treated with proximal occlusion and three were circumferentially "wrapped". Parent artery occlusion caused one death and one mild disability and the remaining patients made good recoveries (follow-up 0.5 - 10 years). CONCLUSIONS: There is a subset of cerebral aneurysms with discrete fusiform morphology, apparently unrelated to cerebral atherosclerosis or systemic connective tissue disease, thin-walled in part or whole, more common in the vertebrobasilar system, and possessing a risk of rupture. Treatments currently available include proximal occlusion or aneurysm wrapping", different approaches than neck-clipping or endovascular coiling of side-wall saccular cerebral aneurysms that leave the parent artery intact.
机译：背景：梭状脑动脉瘤是脑动脉段整个圆周的扩张，通常认为是成年人的动脉粥样硬化所致。它们相对较厚且长壁，发现后会引起神经压迫或局部缺血。我们已经注意到了梭形脑动脉瘤的一个子集，该子集与该常见描述有所不同。患者：经过11年治疗的一系列472例颅内动脉瘤中，有11例年龄在16至67岁（平均年龄37岁）之间，患有离散性梭状动脉瘤，与广义脑动脉粥样硬化，结缔组织疾病或炎症无关。偶然发现了三个出血，六个由于动脉瘤而受到神经压迫，另外两个被发现。结果：九个动脉瘤位于后循环中，另外两个位于颅内颈动脉中。它们的平均长度和宽度分别为16.3和11毫米。三个动脉瘤包含血栓。通过外科手术暴露的八个动脉瘤的壁部分或基本上是薄壁的，具有正常的亲代动脉。八名接受近端咬合治疗，三名被周向“包裹”。父母动脉闭塞导致1例死亡和1例轻度残疾，其余患者恢复良好（随访0.5-10年）。结论：有一小部分脑动脉瘤具有梭形形态，显然与脑动脉粥样硬化或全身性结缔组织病无关，部分或全部薄壁，在椎基底动脉系统中较常见，并具有破裂的风险。目前可用的治疗方法包括“近端闭塞或动脉瘤包裹”，其方法与保留亲代动脉完整的侧壁囊状脑动脉瘤的颈部夹钳或血管内盘绕术不同。

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