Case of Behçet's disease complicated by oculomotor nerve palsy associated with internal carotid artery‐posterior communicating artery aneurysm
Case of Behçet's disease complicated by oculomotor nerve palsy associated with internal carotid artery‐posterior communicating artery aneurysm
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白塞氏病并发颈内动脉-后交通动脉瘤并发动眼神经麻痹一例
DOI：
10.1111/1346-8138.12752
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发表时间：
2015
期刊：
影响因子：
--
通讯作者：
I. Katayama
中科院分区：
文献类型：
--
作者：
T. Yamaoka;H. Murota;I. Katayama
behet病（BD）是一种病因不明的复发性全身性炎症性疾病，涉及全身性血管炎。BD的血管炎是由于各种大小的动脉、静脉和血管受累而引起的，这导致了这种疾病的三种主要表现：静脉闭塞、动脉闭塞和动脉瘤形成。因此，BD患者应始终考虑全身血管受累。在这里，我们描述了首次出现的颈内动脉后交通动脉瘤，导致BD患者完全动眼神经麻痹。摘要一名44岁的日本男性，下肢结节性红斑复发2年。他的病情被诊断为不完全型双相障碍，基于复发性口腔和生殖器溃疡，皮肤疹，如结节性红斑和毛囊炎，病理试验阳性和全身关节痛。在他最初的临床表现十年后，他出现了右侧上睑下垂和右侧颞区周期性钝痛的表现。磁共振成像和血管造影显示右侧颈内动脉-后交通动脉动脉瘤。虽然以前没有报道过BD患者伴有颈内动脉后交通动脉瘤的动眼神经麻痹，但我们的报告强调了在血管BD患者中应该考虑这种异常表现。
Behçet's disease (BD) is a relapsing systemic inflammatory disorder of unknown etiology involving systemic vasculitis. Vasculitis in BD results from the involvement of arteries, veins and blood vessels of all sizes, which leads to the three major manifestations of this condition: venous occlusion, arterial occlusion and aneurysm formation. Therefore, whole‐body vascular involvement should always be considered in BD patients. Here, we describe the first appearance of an internal carotid‐posterior communicating artery aneurysm, resulting in complete oculomotor nerve palsy in a BD patient. A 44‐year‐old Japanese man suffered from recurrent episodes of erythema nodosum that had presented on the lower extremities for the past 2 years. His condition was diagnosed as an incomplete type of BD based on relapsing oral and genital ulcers, skin eruptions, such as erythema nodosum and folliculitis, a positive pathergy test and systemic arthralgia. Ten years after his initial clinical presentation, he had manifestations of right‐sided ptosis and cyclic dull pain in his right temporal region. Magnetic resonance imaging and angiography revealed a right internal carotid artery‐posterior communicating artery aneurysm. Although oculomotor nerve palsy associated with internal carotid artery‐posterior communicating artery aneurysm in a BD patient has not been reported previously, our report highlights the fact that this abnormal manifestation should be considered in those with vasculo‐BD.