Bilateral Internal Carotid Artery Aneurysms at the Subpetrosal Portion with Unilateral Lower Cranial Nerve Palsies: Review and Consideration of Surgical Strategy.
Bilateral Internal Carotid Artery Aneurysms at the Subpetrosal Portion with Unilateral Lower Cranial Nerve Palsies: Review and Consideration of Surgical Strategy.
复制标题
双侧岩下部分颈内动脉瘤伴单侧下颅神经麻痹：手术策略的回顾和考虑。
DOI：
10.1016/j.jstrokecerebrovasdis.2016.12.033
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Morioka M.
中科院分区：
文献类型：
--
作者：
Noguchi K;Aoki T;Sakamoto R;Orito K;Takeuchi Y;Hirohata M;Morioka M.
BackgroundSymptomatic双侧颅外颈内动脉（伊卡）动脉瘤在岩下部分是非常罕见的，他们的治疗策略仍然unknown.Clinical PresentationA 42岁的男子到我们医院与2个月的历史突然发作的声音嘶哑，构音障碍，吞咽困难。磁共振成像、磁共振血管造影和计算机断层扫描血管造影显示岩下部分的颅外双侧伊卡动脉瘤。左侧动脉瘤压迫左侧下颅神经（IX、X、XI和XII），而右侧动脉瘤无症状。我们优先治疗右侧动脉瘤，以防止双侧下颅神经缺损。使用该策略是因为动脉瘤治疗不能保证治愈持续2个月的左侧颅神经麻痹。右侧伊卡动脉瘤采用伊卡结扎和高流量颅内外旁路术治疗，使用桡动脉作为旁路移植物。17天后对左侧伊卡动脉瘤进行了支架辅助弹簧圈栓塞。患者没有表现出右侧症状，他的左侧症状显着改善1年后surgery.ConclusionOur独特的手术策略，优先考虑动脉瘤的“无症状”的一面可能是最好的治疗方法之一，在一个非常罕见的双边动脉瘤的情况下。
BackgroundSymptomatic bilateral extracranial internal carotid artery (ICA) aneurysms at the subpetrosal portion are extremely rare, and their treatment strategy remains unknown.Clinical PresentationA 42-year-old man presented to our hospital with a 2-month history of sudden onset of hoarseness, dysarthria, and dysphagia. Magnetic resonance imaging, magnetic resonance angiography, and computed tomography angiography revealed extracranial bilateral ICA aneurysms at the subpetrosal portion. The left-sided aneurysm compressed the left-sided lower cranial nerves (IX, X, XI, and XII), whereas the right-sided aneurysm was asymptomatic. We prioritized the treatment of the right-sided aneurysm to prevent bilateral lower cranial nerve deficits. This strategy was used because aneurysm treatment is not guaranteed to cure the left-sided cranial nerve palsies that lasted for 2 months. The right-sided ICA aneurysm was treated with ICA ligation and high-flow extracranial–intracranial bypass using the radial artery as bypass graft. Stent-assisted coil embolization was performed to the left-sided ICA aneurysm after 17 days. The patient showed no right-sided symptoms, and his left-sided symptoms remarkably improved 1 year after surgery.ConclusionOur unique surgical strategy of prioritizing the aneurysm on the “asymptomatic” side may be one of the best treatment approaches in an extremely rare bilateral aneurysm case.
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影响因子：
1.5
作者：
O. Reslan;J. L. Ebaugh;J. Raffetto
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影响因子：
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作者：
C. Spitzer;M. Mull;R. Töpper
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影响因子：
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作者：
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A. Valavanis
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DOI：
10.3174/ajnr.a1135
发表时间：
2014
期刊：
Revista medica del Instituto Mexicano del Seguro Social
影响因子：
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作者：
Luz del Carmen Martínez;A. González;L. H. Govea;M. D. Macías;C. Fuentes
通讯作者：
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影响因子：
4.4
作者：
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通讯作者：
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