Dissecting Aneurysm of the Vertebro-basilar Artery
Dissecting Aneurysm of the Vertebro-basilar Artery
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椎基底动脉夹层动脉瘤
DOI：
10.2176/nmc.24.343
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发表时间：
1984
期刊：
影响因子：
--
通讯作者：
S. Abe
中科院分区：
文献类型：
--
作者：
M. Yokoyama;I. Kurita;M. Yamashita;G. Uemura;Y. Yoshida;S. Abe
本文报告一例经血管造影及组织学诊断的椎基底动脉夹层动脉瘤。一名31岁女性突然出现严重头痛和呕吐。入院时，9小时后，患者嗜睡，弥漫性脑干病变的迹象明显。脑脊液、头颅X线片和计算机断层扫描未发现异常。左侧椎动脉造影显示基底动脉内膜分离，侧位投影上为“双腔”。患者接受保守治疗，但12天后死于脑干出血。病理检查显示夹层发生了两次：第一次内膜下夹层始于左侧椎动脉距椎联合近端15 mm处，并延伸至左侧小脑前下动脉近端部分;第二次夹层发生在基底动脉并导致脑干出血。椎-基底动脉系统夹层动脉瘤，特别是累及基底动脉的夹层动脉瘤，预后极差，作者认为，在早期，基于正确的血管造影诊断，进行外科手术，如结扎、圈套或吻合，是最有益的。
A case of dissecting aneurysm of the vertebro-basilar artery diagnosed angiographically and histologically is reported. A 31-year-old female suddenly developed severe headache and vomiting. On admission, 9 hours later, the patient was somnolent, and signs of diffuse brain stem lesion were manifest. Cerebrospinal fluid, craniogram, and computerised tomography scan showed no abnormal findings. Left vertebral angiography showed intimal separation of the basilar artery as a “double lumen'” on lateral projection. The patient was given conservative treatment, but died 12 days later of brain stem hemorrhage. Pathological examination showed that the dissection occurred twice: the first subintimal dissection started at the left vertebral artery 15 mm proximal to the vertebral union, and extended to the proximal portion of the left anterior inferior cerebellar artery; the second dissection occurred in the basilar artery and caused the brain stem hemorrhage. The prognosis for dissecting aneurysm of the vertebro-basilar system, especially involving the basilar artery, is very poor, and the authors think that surgical procedure, such as ligation, trapping, or anastomosis, in the early stage, based on a correct angiographical diagnosis, is most beneficial.