大脑后动脉夹层动脉瘤

椎基底动脉的夹层动脉瘤较少见,而位于大脑后动脉的则更为罕见。本文报道1例大脑后动脉夹层动脉瘤。患者,女,24岁,有偏头痛史,处口服避孕药期。自诉看电视时突然额部痛,眩晕,右视野障碍和右半身感觉异常。入院检查,右视野缺损,右轻偏瘫和右手运动失调;血细胞计数、沉降率、蛋白电泳、血清胆固醇和血凝时间正常,心电图和胸部 X 线检查正常;腰穿为血性脑脊液,红细胞11.52×10~(12)/L,白细胞20×10~9/L,蛋白4000mg/L,离心沉淀后无色素沉看。CT 显示左枕额部低密度区,同日穿刺4血管显示在左大脑后动脉近端1cm 处有两个“腊肠样”肿胀,伴有双腔,超声心动图报告为不规则的二     

026自发性颈部总动脉夹层分离:1例报告及文献复习

颈内动脉(ICA)颅外段夹层分离是脑梗死的常见病因，占年青人缺血性率中的20．5％，而自发性颈总动脉(CCA)夹层分离罕见，且常伴主动脉夹层分离，单独CCA夹层分离更罕见，现报道1例。     

自发性孤立性肠系膜上动脉夹层1例并文献复习

<正>病例:患者男性,51岁,因"腹痛3 h,呕血1 h"于2013-12-24至松滋市人民医院消化内科就诊。患者3 h前进食后出现上腹部、脐周持续性隐痛,阵发性加重。1 h前出现恶心,间断性呕吐3次,初为非咖啡样胃内容物,后两次为咖啡样胃内容物,约10 m L,呕吐后仍感腹痛,无便血、黑便、头晕、心悸、尿量减少等表现,遂收入院治疗。患者既往体健,     

POEMS综合征：1例报告并文献复习

POEMS综合征是一种与浆细胞有关的多系统病变,临床上以进行性多发性周围神经病变（P）、脏器（肝脾）肿大（O）、内分泌紊乱（E）、M蛋白增高（M）和皮肤改变（S）为特征,常伴有全身凹陷性水肿、胸腹水、杵状指（趾）和心力衰竭等症状。我们报道1例男性38岁患者,因“腹胀、双下肢水肿2年,四肢远端麻木2月”入院,经临床各种检查被诊断为该病。我们复习了有关POEMS综合征的临床特征和诊治进展。     

垂体瘤伴大脑中动脉瘤一例报告及文献复习

患者,男,42岁,辽宁人,满族,农民。于2007年3月28日,因双眼视力下降逐渐加重3个月,在当地眼科就诊未清原因来中国医科大学第一附属医院。病史中未见"肢端肥大"、"高血压"、"肥胖"、"性动能障碍"、"泌乳"、头痛等异常。既往史、个人史、家族史无特殊。查体:生命体征     

卵圆孔未闭致大脑中动脉闭塞:1例报道并文献复习

近年来,随着缺血性卒中病因学分型理论的普及[1],隐源性卒中的病因研究逐渐受到重视.隐源性卒中是指经过全面筛查仍不能明确病因的缺血性卒中,约占所有缺血性卒中的20％[2].多达40％的隐源性卒中患者伴有卵圆孔未闭(patent foramenovale,PFO),尤其是年轻患者.一般认为,PFO是卒中的独立危险因素,当其造成明显的右向左分流(right to left shunt,RLS)时,容易发生反常性栓塞[3].PFO所致的脑栓塞通常为单一皮质病变或椎基底动脉供血区的多发性小梗死灶,大血管栓塞很少见[4-5].我们报道了1例PFO导致大脑中动脉(middle cerebral artery,MCA)闭塞的病例.     

大脑前动脉附属动脉远端动脉瘤破裂:病例报告

大脑前动脉(ACA)附属动脉是异常3支ACA中的一支中间动脉,临床上并不少见。但出现动脉瘤极其罕见。作者报道1例起自ACA附属动脉远端动脉瘤破裂的罕见病例,并对其特点、成因及该异常的分类作了探讨。 男性,63岁,因突发剧烈头痛,随即意识丧失、双下肢截瘫而急诊入院。头颅CT示厚层、弥漫性SAH伴     

肠系膜上动脉瘤合并梗阻性黄疸1例报道并文献复习

肠系膜上动脉瘤压迫导致梗阻性黄疸的病例非常罕见,治疗方式以手术为主。现报道我院收治的1例患者的治疗经过,供临床参考。     

Main pulmonary artery aneurysm: a case report and review of the literature.

Main pulmonary artery aneurysms are a rare entity with few available published data. As reported in the literature, operative treatment is commonly recommended but the relation between the size of the aneurysm, its localization, and the risk of rupture is not as well defined as for aortic aneurysms. Proximal lesions that involve the main branches of the pulmonary artery are usually apparent on chest radiographs and must be taken into consideration in the differential diagnosis of mediastinal masses. An early diagnosis allows timely surgical treatment. We report an unusual case of a main pulmonary artery aneurysm presenting with persistent non-productive cough and provide a review of the pertinent published data.     

Inferior mesenteric artery aneurysm: case report and literature review.

A 70 year old man presented with retrosternal and epigastric pain. He was in shock. The diagnosis on admission was acute myocardial infarction. CT scan of the abdomen showed coeliac and superior mesenteric artery (SMA) occlusion. In addition there appeared to be large collateral from the inferior mesenteric artery (IMA) with a retroperitoneal collection. He underwent emergency laparotomy and a ruptured IMA aneurysm was detected. The aneurysm was excised and the IMA was ligated. He developed progressive multi-system organ failure post operatively. We discuss the aetiology, presentation, diagnosis and treatment of IMA aneurysms.     

Spontaneous rupture of a coronary artery aneurysm: a case report and review of the literature

Coronary artery aneurysm (CAA) is a rare disorder, characterized by abnormal dilatation of a localized portion or diffuse segments of the coronary artery. CAA may cause angina, myocardial infarction, sudden death due to thrombosis, embolisation, or rupture. In this report, a 63 year old Turkish male patient is presented who had an acute non-Q wave myocardial infarction due to spontaneous rupture of the left circumflex artery aneurysm. An extremely rare clinical presentation of rupture of a left circumflex CAA is discussed.     

Recurrent spontaneous coronary artery dissection: A case report and review of the literature

Spontaneous coronary artery dissection is a rare cause of acute coronary syndrome. Recurrent spontaneous dissection is even more rare. A case of recurrent coronary artery dissection is reported and the literature is reviewed.     

Vertebral artery dissection following intravascular catheter placement: a case report and review of the literature

Vertebral artery dissections (VAD) are known to occur as a result of mechanical manipulations of the cervical region, traumatic injury, iatrogenic injury and are also known to arise spontaneously. We report a case of vertebral artery dissection following vertebral artery cannulation during a central line placement and review the literature. The patient underwent intravascular catheter placement that subsequently demonstrated arterial blood. Duplex ultrasound and computed tomographic (CT) scan confirmed vertebral artery cannulation. The catheter was removed at the bedside with pressure, and a subsequent duplex ultrasound scan revealed a vertebral artery dissection. There were no neurological sequelae. The patient was successfully anticoagulated with warfarin but died from unrelated complications. This case report describes the rare iatrogenic event of VAD and reviews its etiology, diagnosis, complications, and management.     

Delayed diagnosis of Kawasaki syndrome and thrombosis of a medium-sized aneurysm of the anterior descending coronary artery: case report and literature review

A 7-year-old child was first admitted for persistent fever of 15-day duration and suspected meningitis. Kawasaki syndrome was lately diagnosed upon the recognition of an extensive diffuse coronary artery damage characterized by medium-sized aneurysms of the epicardial vessels. An eccentric thrombus along the inferior wall of the left anterior descending artery suspected at transthoracic echocardiography was confirmed by coronary computed tomography angiography scan, without significant segmental stenosis. Strict cardiac surveillance and anticoagulant therapy were maintained, and no ischemic complications occurred at a short-term follow-up. This report emphasizes that thrombosis can be observed even in medium-sized aneurysms when the diagnosis of Kawasaki syndrome is delayed.     

Coronary artery stenting for spontaneous coronary artery dissection: A case report and review of the literature

Spontaneous coronary artery dissection is an uncommon cause of acute coronary syndromes. It occurs in three major groups: in young women in the peripartum period, in patients with atherosclerotic disease, and in an idiopathic group. There are a number of associated conditions, but the pathogenesis remains unclear. Diagnosis can only be made at angiography. Treatments include medical therapy, coronary artery bypass grafts, and newer interventional procedures. We report on a case of spontaneous coronary artery dissection involving the left circumflex artery in a young adult male presenting with a myocardial infarction after exercise. There were no risk factors for coronary artery disease and no evidence of atherosclerosis on angiography. The dissection was treated with primary coronary artery stenting without predilation, achieving an excellent result. To our knowledge, this is the third known case of successful coronary artery stenting for this condition and the first case of primary stenting without prior angioplasty. Cathet. Cardiovasc. Diagn. 45:280–286, 1998. © 1998 Wiley-Liss, Inc.     

布氏杆菌感染性腹主动脉瘤腔内治疗1例——病例报道及文献复习

感染性动脉瘤较为罕见,而布氏杆菌感染引起腹主动脉瘤极为罕见。感染性主动脉瘤经典的治疗术式是彻底清创,解剖外建立血管通路,结合围术期应用抗生素治疗。但近年来主动脉腔内修复术的应用逐渐有了较多的报道,且取得较好的疗效。我们报道了感染性腹主动脉瘤患者行腔内修复术1例并进行相关文献复习。作者回顾1例布氏杆菌引起的感染性腹主动脉瘤患者的临床资料。该患者为76岁男性,之前无相关感染病史。主要表现为发热、腹部搏动性包块和腰腹部疼痛。术前外周血培养提示布氏杆菌感染,给予多西环素治疗有效。CT血管造影提示腹主动脉远端假性动脉瘤。入院后行腔内修复术,术后继续应用敏感抗生素治疗,定期随访。回顾之前发表的其他病例数据,总结布氏杆菌感染性腹主动脉瘤腔内治疗的相关经验。经血管腔内放置覆膜支架修复联合抗生素治疗,手术成功;出院后随访4个月,随访4个月后,患者生命体征正常。因此,对于布氏杆菌引起的感染性动脉瘤,在术前充分抗感染、控制血压,术后长期应用抗生素的前提下,进行腔内修复治疗的思路是可行的。