Nonaneurysmal Subarachnoid Hemorrhage Due to Unfused or Twiglike Middle Cerebral Artery Rupture: Two Case Reports
Nonaneurysmal Subarachnoid Hemorrhage Due to Unfused or Twiglike Middle Cerebral Artery Rupture: Two Case Reports
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未融合或树枝状大脑中动脉破裂导致的非动脉瘤性蛛网膜下腔出血：两个病例报告
DOI：
10.1016/j.jstrokecerebrovasdis.2016.03.029
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发表时间：
2016
期刊：
影响因子：
--
通讯作者：
T.
中科院分区：
文献类型：
--
作者：
Tashiro;R. Inoue;T. Shibahara;I. Ezura;M. Uenohara;H. Fujimura;M. Tominaga;T.
大脑中动脉（MCA）是一种与大脑中动脉发育异常有关的先天性畸形。未融合或树枝状的MCA可引起缺血性和出血性中风。以往的报道表明，未融合或树枝状MCA与动脉瘤共存可引起蛛网膜下腔出血（SAH）。两例患者均存在左侧MCA近端M1段狭窄以及狭窄病变远端异常血管网。异常血管网远端的血管系统大体上保持正常。这些发现在计算机断层扫描或磁共振血管造影中并不明显。结论未融合或树枝状MCA可引起非蛛网膜下腔出血。数字减影血管造影是准确诊断所必需的。
BackgroundAn unfused or twiglike middle cerebral artery (MCA) is a congenital anomaly related to the abnormal development of the MCA. An unfused or twiglike MCA can cause both ischemic and hemorrhagic strokes. Previous reports have shown that an unfused or twiglike MCA with coexisting aneurysms can cause subarachnoid hemorrhage (SAH).CasesTwo patients presented with nonaneurysmal SAH due to an unfused or twiglike MCA. Both patients had stenosis of the proximal M1 segment of the left MCA and abnormal vascular nets distal to the stenotic lesion. Vasculature distal to the abnormal vascular nets remained grossly normal. These findings were not evident in computed tomography or magnetic resonance angiography.ConclusionAn unfused or twiglike MCA can cause nonaneurysmal SAH. Digital subtraction angiography is necessary for accurate diagnosis.