大脑前动脉远端动脉瘤致假瘤样脑内血肿一例

<正>1 病例简介患者,男,37岁,因"头痛、记忆力下降6个月"于2009年5月31日入院。患者于6个月前无明显诱因感左枕部闷痛,呈持续性,间断有头痛加重,严重时影响睡眠,不伴头晕、恶心,无肢体抽搐、无力,     

锁骨下动脉支架术后闭塞再通1例报道

正1病例介绍患者,男性,57岁,主因"头痛、头晕2.5年,加重半个月"于2013年4月25日入院,患者于2.5年前(2010年8月)无明显诱因出现头痛、头晕,头痛以后枕部钝痛为主,不伴视物旋转,无恶心呕吐,无明显肢体麻木无力,于当地医院行颅脑计算机断层扫描(computed tomography,CT)未见明显异常,测双侧血压不一致(具体数值不详),继而行头颈     

个体化诊疗脑动脉夹层3例病例介绍

正1病例介绍病例1患者女性,17岁,学生,因"左侧肢体麻木5 h"于2010年4月4日入院。患者5 h前在舞蹈时头部后仰,突发左侧肢体麻木伴头晕,并有头颈部疼痛不适,无明显肢体乏力。急诊入我院治疗。既往史:患者既往体健,无手术外伤史,无食物药物过敏史,无输血史,无传染病史,否认精神疾病史及其家族史。     

复杂大脑中动脉动脉瘤1例

颅内复杂动脉瘤无论是血管内栓塞还是手术夹闭难度均较大。最近我科采用支架分割血管内栓塞术治疗复杂大脑中动脉动脉瘤1例,现报道如下。1病例报告患者男性,58岁,因“突发头痛,头晕1d,反应迟钝半天”人院。入院查体：BPl67／85mmHg,嗜睡,GCS13分;两侧瞳孔等大等圆,直径约2．0mm,对光反射灵敏;呼唤能应,能简单遵医嘱运动;Hunt—Hess分级3级,颈抵抗明显,四肢肌力v级,两侧巴氏征阴性。     

载瘤动脉闭塞治疗基底动脉巨大动脉瘤1例

正患者,女,16岁,因间断头痛伴恶心呕吐2周,于2014年11月27日入住大连医科大学附属第一医院介入治疗科。患者入院2 w前无明显诱因,出现间断头痛,为全颅胀痛,伴恶心、呕吐多次,至外院行头颅MRI提示颅内动脉瘤,进一步行CTA检查确诊为基底动脉动脉瘤,为进一步诊治入住我科。查体:无阳性神经系统定位体征。辅助检查:头颅MRI示桥前池占位,脑桥及第四脑室受压;头颈部CTA示基底动脉近段囊状突起,累及双侧椎动脉末端,考虑动脉瘤。患者病灶为症状性未破裂动脉瘤,瘤体巨大,为防止动脉瘤破裂出血及瘤体增     

锁骨下动脉支架成形术后高灌注综合征1例分析

1病例介绍
　　患者,女,66岁,因“反复头晕伴左上肢麻木3个月”于2011年4月7日收入院。患者入院3个月前无明显诱因出现阵发性头晕,伴左上肢麻木,冷感,站立位头晕加重,无头痛、恶心、呕吐,无肢体活动障碍,无视物成双,无饮水呛咳,持续10余分钟后缓解或症状减轻;类似症状反复出现。期间患者曾多次自行到社区输液治疗（具体不详）,症状无明显改善,头晕发作日见频繁,起初每2～3 d发作1次,现加重至每天发作3～4次,门诊就诊时发现患者双侧血压不对称,左侧无脉,血压测不到,右上肢血压130/80 mmHg,诊断考虑后循环缺血,为进一步治疗收住院。     

完全血栓化的大脑中动脉动脉瘤2例报告并文献复习

目的探讨完全血栓化的大脑中动脉动脉瘤的临床特征及治疗方式。方法回顾性分析2例完全血栓化的大脑中动脉动脉瘤患者的临床资料,并对相关文献进行复习。结果本组2例患者均为中年女性,表现为头痛(不剧烈)和发作性头晕。经头颅CT、MRI和DSA检查诊断为完全血栓化的大脑中动脉动脉瘤;予以观察随访。结合文献复习,完全血栓化的颅内动脉瘤以女性多见,首发症状多为头痛,均为未破裂动脉瘤,多发于大脑中动脉。其术前易误诊为颅内海绵状血管瘤或肿瘤等,多采用动脉瘤孤立切除或血管重建术治疗。结论完全血栓化的大脑中动脉瘤易与颅内海绵状血管瘤等相混淆。当病灶位于动脉主干或分支远端时,应高度考虑完全血栓化的动脉瘤存在;若其无占位效应,则以观察为主,定期随访复查。     

结节性硬化合并破裂脑动脉瘤1例

<正>结节性硬化(tuberous sclerosis complex,TSC)是一种常染色体显性遗传性疾病,又称Bouneville病。TSC可累及全身多个器官和系统,包括脑、肾脏、视网膜、皮肤、脾脏、心脏、骨骼和肺等,以肾脏为最多见[1]。TSC累及血管时主要为外周大、中动脉,颅内动脉较少受累,因此,TSC合并脑动脉瘤报道甚少[2],目前国内尚无报道。本文将报道1例新发病例,并探讨结节性硬化合并脑动脉瘤的临床表现、发病机制、早期诊断及治疗。1资料患者,女,60岁。因突发头晕、头痛2d急诊入院。既往智力正常,无痫性发作病史。20年前因"左肾肿瘤伴出     

难于手术的巨大囊形基底动脉瘤一例

1病例简介患者,男,64岁,因“头痛2年加重5个月、双下肢无力1d”于2005-05-18入院。患者2年前因“持续性头痛”于外院行颅脑强化CT示基底动脉瘤,给予药物治疗(具体不详)后症状好转。此后头痛反复发作,近5个月来头痛发作频繁,伴有饮水呛咳、精神不振、头晕、偶伴视物成双,无恶心呕     

非对称性脑积水1例报告

1 临床资料 患者女,41岁,1年前有蛛网膜下腔出血史,给予药物治疗后好转,CTA检查未发现动脉瘤病变及血管畸形,4个月前出现头痛、头晕、记忆力减退,2个月前出现恶心、呕吐;均逐渐加重入院。体格检查：神志清,左侧视盘水肿严重,并有视神经萎缩,右侧视盘水肿较轻,右侧肢体肌力Ⅳ级,右侧巴宾斯基征阳性。行脑部CT检查示：双侧侧脑室积水,左侧较右侧严重。     

External Carotid Artery Angioplasty and Stenting Followed by Superficial Temporal Artery to Middle Cerebral Artery Anastomosis

A 31-year-old man presented with right hemiparesis, and magnetic resonance imaging revealed a small infarct at left basal ganglia. Digital subtraction angiography showed left cervical internal carotid artery (ICA) occlusion and severe stenosis of the ipsilateral external carotid artery (ECA) with collateral cerebral circulation fed by ECAs. Based on the results of a functional evaluation of cerebral blood flow, we performed preventive ECA angioplasty and stenting for advanced ECA stenosis to ensure sufficient blood flow to the superficial temporal artery. Eight weeks later, superficial temporal artery to middle cerebral artery (STA-MCA) anastomosis was performed. His postoperative course was uneventful and no additional transient ischemic attacks have occurred. To our knowledge, this is the first report of preventive angioplasty and stenting for advanced narrowing of an ECA before STA-MCA anastomosis for ipsilateral ICA occlusion.     

Transposition of Anterior Choroidal Artery and Posterior Communicating Artery Origin

The anterior choroidal artery has several kinds of variations. Among them, the transposition of anterior choroidal artery and posterior communicating artery origins has been extremely rare. We report a case with cerebral aneurysm arising from posterior communicating artery which origin was distal to the anterior choroidal artery and review the relevant literature.     

Superficial Temporal Artery-Middle Cerebral Artery Anastomosis for Internal Carotid Artery Occlusion by Subacute In-Stent Thrombosis after Carotid Artery Stenting

Alternative to carotid endarterectomy, carotid artery stenting (CAS) can be performed for symptomatic severe stenosis of internal carotid artery, especially for high-risk patients. Among several complications after CAS, subacute in-stent thrombosis is rare but important, because patient''s condition can deteriorate rapidly. Subacute in-stent thrombosis with carotid artery occlusion can be managed by superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis. We report two cases of STA-MCA anastomosis for internal carotid artery occlusion by subacute in-stent thrombosis after CAS.     

Hemodynamic Effects of Innominate Artery Occlusive Disease on Anterior Cerebral Artery

Stenoses of the innominate artery (IA) may affect flow conditions in the carotid arteries. However, alternating flow in ipsilateral anterior cerebral artery (ACA) due to IA stenosis is extremely rare. A 49-year-old woman who was evaluated for symptomatic cerebrovascular disease presented with right latent subclavian and right carotid system steal. Transcranial Doppler examination displayed systolic deceleration wave-forms in the right terminal internal carotid artery and alternating flow in the right ACA. Magnetic resonance angiography demonstrated tight stenosis of the right IA. For a thorough study of the hemodynamic effects of IA stenosis, a combination of duplex and transcranial Doppler examination is required.     

Aberrant Ascending Pharyngeal Artery Mimicking a Partially Occluded Internal Carotid Artery

Doppler sonography has become a primary imaging modality for the diagnosis of carotid arterial stenosis. Carotid stenting for a severely stenotic but not completely occluded carotid artery is becoming an alternative to carotid endarterectomy in selected groups of patients. The authors discuss a case of complete occlusion of the internal carotid artery associated with an ipsilateral aberrant ascending pharyngeal artery originating from the proximal internal carotid artery, which mimicked a stenotic internal carotid artery on sonography. Meticulous Doppler sonographic examination may provide clues for this extraordinary condition, yet angiography is indicated for a definite diagnosis.