小脑前下动脉综合征1例报告

患者,男,６９岁。因突发眩晕、视物旋转、呕吐、行走不稳和左耳聋５天于２００１年３月９日入院。既往有高血压病史５年。查体：血压２６．７／１３．３ｋＰａ,神清、语明．心肺（－）。双眼向右倒凝视,向左倒凝视时可见永平眼震,左侧Ｈｏｒｎｅｒ征,左侧面部痛觉减低,左侧周围性面瘫,左倒角膜反射消失。左耳聋。四肢肌力、肌张力、腱反射正常,锥体束征（－）。右侧颈以下肢体躯于痛觉减低。左创指鼻试验、跟膝腔试验不准。血糖：４．９２ｍｍｏｌ／Ｌ,胆固醇５．７３ｍｍｏｌ／Ｌ、甘油三脂１．８ｍｍｏｌ／Ｌ、高密度脂蛋白１．…     

小脑前下动脉梗死1例报告

小脑前下动脉梗死 ,临床上罕见 ,现报告 1例如下。1　病例　男 ,6 8岁。因眩晕、口角歪斜 6小时于 1999年 11月 2 7日入院。入院前 18小时活动中出现头晕伴恶心 ,无视物旋转 ,约 2小时缓解。 6小时前晨起出现视物旋转、言语不清、口角歪斜、右面部麻木、右外耳道针刺样疼痛、耳鸣、耳聋及吞咽困难、饮水呛咳。平素体健 ,否认高血压病史。查体 :意识清楚 ,构音障碍 ,颜面无汗。双眼可见水平及旋转眼震 ,右面部针刺觉减退 ,右额纹消失 ,鼻唇沟变浅 ,右眼裂大 ,右眼闭合困难 ,示齿口角左偏 ,右耳音叉试验为骨导 >气导。软腭运动差。四肢肌力 …     

小脑前下动脉梗死综合征16例分析

小脑前下动脉梗死(AICA)是由于小脑前下动脉血栓形成或基底动脉闭塞所致。临床表现可有：眩晕，病变同侧共济失调。耳鸣耳聋，周围性面瘫。面部痛觉减退，Horner征，向病灶侧同向凝视麻痹，对侧肢体痛温觉减退。其中第Ⅶ颅神经受累是其特征性表现。1998年～2004年2月我科共收治该病患者16例，现总结如下。     

小脑前下动脉动脉瘤手术夹闭1例

小脑前下动脉(anterior inferior cerebellar artery, AICA)动脉瘤非常罕见,发病率在颅内动脉瘤中不足1%,远端动脉瘤更少见,约占0.1%[1],现结合文献报告如下. 1 资料 患者,男,57岁,头痛头晕10 d,加重伴意识障碍、四肢抽搐1 d于2008年9月13日入院.院外头颅CT示蛛网膜下腔出血.意识模糊,GCS评分12分,颈抵抗,克氏征(+),四肢肌力Ⅳ级.入院后3 d行全脑血管造影检查示:左侧AICA远端近内听孔处动脉襻发出一个3 mm×3 mm的类圆形动脉瘤,窄颈,顶部朝向外侧(图1).诊断:左侧AICA远端动脉瘤,Hunt-Hess分级Ⅲ级.     

小脑前下动脉梗死的临床及影像学特点

目的探讨小脑前下动脉（AICA）梗死的临床及影像学特点。方法回顾性分析32例患者的临床资料。结果AICA梗死绝大多数以眩晕、小脑性共济失调为首发表现，第Ⅷ对颅神经受累是其特征性表现。MRI上表现为桥脑外下侧或（和）小脑中脚区域的梗死。AICA梗死预后较好，但有可能进展为基底动脉梗死。结论AICA梗死的诊断主要依靠MRI，预后较好。     

小脑前下动脉瘤五例报告

目的探讨小脑前下动脉（AICA）动脉瘤的临床特征、治疗方式的选择及操作技巧。方法回顾性分析5例AICA动脉瘤的临床资料。结果AICA远端囊性动脉瘤3例，其中2例位于内听道口，1例化于小脑绒球腹侧、面听神经背侧，并伴有同侧小脑半球小型隐匿性血管畸形，术中借助神经内镜发现动脉瘤，3例均行手术夹闭，并于术后住院期间行脑血管造影复查，夹闭满意；AICA近端囊性动脉瘤2例，均采用血管内介入治疗。患者预后优4例，良1例。结论AICA远端动脉瘤宜首选手术夹闭，术是辅助神经内镜有助于提高显微手术效果；AICA近端动脉瘤宜首选血管内介入治疗。     

小脑前下动脉闭塞综合征32例临床分析

小脑前下动脉闭塞综合征是由小脑前下动脉或基底动脉闭塞引起,临床主要表现有眩晕、病变同侧共济失调、耳鸣耳聋、周围性面瘫、面部痛觉减退、Horner征,向病灶侧同向凝视麻痹,对侧肢体痛温觉减退,其中第Ⅷ脑神经受累是其特征性表现.1999～2006我科诊治32例该病患者,现分析如下.     

小脑前下动脉梗死的临床与磁共振成像的研究

目的 研究小脑前下动脉(AICA)梗死的临床表现及磁共振成像(MRI)特征。方法 对我院1997年1月～2001年6月4年半间通过磁共振成像(MRI)确诊的19例AICA梗死患者进行临床及MRI观察。结果AICA梗死占同期急性脑梗死的1.47％,占同期小脑梗死22.1％。危险因素与一般缺血性脑卒中午相似,即高血压、高脂血症、糖尿病是其主要的危险因素。所有患者均有眩晕及小脑性共济失调的症状体征;除一名患者外均有颅神经受累,以Ⅷ、Ⅶ、v最多见。第Ⅶ颅神经受累是AIcA梗死的一个特征性改变。AICA梗死预后较好。结论 AICA梗死并非罕见,应提高对AICA梗死临床表现及MRI特征的认识,以降低临床误诊率。     

经乙状窦后入路小脑前下动脉显微解剖学研究

目的 研究小脑前下动脉(AICA)的显微解剖学特点及临床应用价值。方法 取6具尸头,经乙状窦后入路,用手术显微镜、神经内镜观察AICA的行程、分支、分布及其与周围结构的关系。结果 共观察到15支AICA,无AICA缺如,AICA发出四组重要的分支:桥延支、内听动脉、回返穿通支和弓状下动脉。AICA紧贴面听神经腹侧行走,并发出分支营养神经。结论 AICA与脑干、面听神经关系密切。听神经瘤手术中应妥善保护其主干及分支,以提高面听神经功能保留率。     

Bilateral Anterior Inferior Cerebellar Artery Territory Infarcts

lilateral anterior inferior cerebellar artery (AICA) territory infarcts are rare. Their ocurrence usually signifies severe intracranial lertebrobasilar disease. Unlike head commuted tomography, magnetic resonance (MR) imaging reveals these infarcts clearly and MR angiography allows the intracranial vasculature to be defined noninvasively. We now report a patient with bilateral AICA territory infarcts.     

Ruptured Total Intrameatal Anterior Inferior Cerebellar Artery Aneurysm

Among the distal anterior inferior cerebellar artery (AICA) aneurysms, a unique aneurysm at the meatal loop inside the internal auditory meatus is extremely rare. The authors report a case of surgically treated total intrameatal AICA aneurysm. A 62-year-old female patient presenting with sudden bursting headache and neck pain was transferred to our department. Computed tomography and digital subtraction angiography showed subarachnoid hemorrhage at the basal, prepontine cistern and an aneurysm of the distal anterior inferior cerebellar artery inside the internal auditory meatus. Surgery was performed by retrosigmoid craniotomy with unroofing of the internal auditory meatus. The aneurysm was identified between the seventh and eighth cranial nerve in the meatus and was removed from the canal and clipped with a small straight Sugita clip. After operation the patient experienced transient facial paresis and tinnitus but improved during follow up.     

Ruptured Intrameatal Aneurysm of the Anterior Inferior Cerebellar Artery Accompanying an Arteriovenous Malformation: a Case Report

The distal anterior inferior cerebellar artery (AICA) aneurysms located inside the internal auditory canal are rare. The association of the distal AICA aneurysms and an arteriovenous malformation (AVM) on the same arterial trunk is exceptional. Eight reports of a total of ten cases have been published and all of the reported aneurysms were located in the meatal or postmeatal segment of the AICA. Herein, we report a case of ruptured aneurysm in the intrameatal portion of the AICA accompanying an AVM fed by the same artery. A 55-year-old man suffering from subarachnoid hemorrhage due to a ruptured intrameatal aneurysm with a small AVM underwent surgical trapping of the meatal loop, resulting in uneventful recovery. Follow-up angiography demonstrated neither aneurysm nor residual AVM nidus. We propose that trapping of the meatal loop could be a safe and feasible alternative to unroofing followed by neck clipping in selected patients with an intrameatal aneurysm of the AICA. We also review here the relevant literature.     

小脑前下动脉瘤11例临床分析

目的 总结小脑前下动脉瘤的临床和影像学特点，以及手术夹闭与介入治疗两种方法的治疗效果。 方法 回顾性分析首都医科大学附属北京天坛医院神经外科2012年1月-2019年12月收治的小脑前 下动脉瘤患者的基线信息、临床表现、动脉瘤特点、治疗方式和治疗效果。 结果 共收治11例小脑前下动脉瘤患者，其中显微外科手术夹闭动脉瘤5例，治愈率100%，术后2例 （40%）出现不完全性失语和手术侧面瘫，随访均无复发；介入治疗6例，5例（83.3%）完全栓塞动脉 瘤，其中2例（33.3%）闭塞动脉瘤远端载瘤动脉，1例（16.7%）栓塞治疗失败，术后1例（16.7%）出现 记忆力下降，1例（16.7%）出院1个月后动脉瘤破裂，并最终死亡。 结论 对于小脑前下动脉瘤，积极干预对于挽救患者生命意义重大，开颅手术夹闭和介入治疗都是 可选的治疗方式，两者均效果确切。     

Transbrachial Stent-Assisted Coil Embolization of Right Posterior Inferior Cerebellar Artery Aneurysm: Technical Case Report

OBJECTIVE AND IMPORTANCE: We describe a case of stent-assisted coil embolization of a wide neck right posterior inferior cerebellar artery (PICA) aneurysm via a transbrachial artery approach. CLINICAL PRESENTATION: A 73-year-old woman with a past medical history of hypertension, hyperlipidemia, colon cancer, and osteoporosis presented with a throbbing occipital area headache. Magnetic resonance angiography revealed a wide neck right PICA aneurysm. She presented for a planned endovascular stent-assisted coil embolization. TECHNIQUE: The initial transfemoral approach was complicated by persistent guide catheter instability due to marked tortuosity of the right vertebral artery (VA). The left VA could not be accessed due to left subclavian occlusion with steal syndrome. Neuroform-2 (Boston Scientific; Natick, MA) stent-assisted Matrix (Boston Scientific; Natick, MA) coil embolization was successfully performed through a 6-French guide catheter using a transbrachial approach. CONCLUSION: Current advances in technology produce neuroendovascular devices that are smaller with increased flexibility, allowing nonfemoral vascular access to the cerebral circulation via alternate arterial routes. This patient case demonstrates transbrachial access is a viable approach for endovascular aneurysm coil embolization, with or without stent assistance, in cases with an unstable guide catheter due to tortuous vessels or abnormal anatomy when femoral access is complicated or contraindicated.     

Trigeminal Neuralgia Caused by an Anomalous Posterior Inferior Cerebellar Artery from the Primitive Trigeminal Artery: Case Report

A 61-year-old woman presented with typical trigeminal neuralgia (TN), caused by an aberrant posterior inferior cerebellar artery (PICA) associated with the primitive trigeminal artery (PTA). Magnetic resonance angiography and digital subtraction angiography clearly showed an anomalous artery directly originating from the PTA and coursing into the PICA territory at the cerebellum. During microvascular decompression (MVD), we confirmed and decompressed vascular compression of the trigeminal nerve by this anomalous, PICA-variant type of PTA. The PTA did not conflict with the trigeminal nerve, and the anomalous PICA only compressed the caudolateral part of the trigeminal nerve, without the more common compression at its root entry zone. This case is informative due not only to its very unusual angioanatomical variation but also to its helpfulness for surgeons preparing a MVD for a TN associated with such a rare vascular anomaly.     

Ruptured Anterior Spinal Artery Aneurysm: A Case Report

We present a case of a subarachnoid hemorrhage and vasospasm secondary to a ruptured anterior spinal artery aneurysm associated with a Chiari 1 malformation. To our knowledge this is the first reported spinal artery aneurysm with this association.