[An autopsy case of persistent primitive hypoglossal artery with multiple cerebral aneurysms].
[An autopsy case of persistent primitive hypoglossal artery with multiple cerebral aneurysms].
复制标题
持续性原始舌下动脉合并多发性脑动脉瘤尸检一例[J].
DOI：
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发表时间：
1988
期刊：
影响因子：
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通讯作者：
Y. Shimbo
中科院分区：
文献类型：
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作者：
Y. Fujii;H. Arai;S. Takeuchi;O. Sasaki;K. Kamada;H. Ogawa;Y. Shimbo
报告1例永存原始舌下动脉（PPHA）合并多发性脑动脉瘤的尸检。一名54岁的男子与蛛网膜下腔出血入院后三天的库瓦纳医院。患者昏迷，颈部僵硬。计算机断层扫描显示纵裂血肿，基底池和双侧侧裂蛛网膜下腔出血，脑室极度扩张。脑血管造影显示左侧PPHA和右侧大脑前动脉（A2）（破裂）、前交通动脉、左侧大脑前动脉（A1）、左侧颈内动脉-脉络膜前动脉交界处、右侧颈内动脉（C1）和右侧大脑中动脉多发动脉瘤。在入院当天进行破裂动脉瘤的颈夹闭和脑室引流。入院后8天，他死于残余动脉瘤破裂。病理学观察显示，PPHA起源于左侧颈内动脉颅外段，距颈动脉分叉处2cm处，经舌下神经孔进入颅内，转入基底动脉。脑血管造影显示6个动脉瘤，1个动脉瘤位于左小脑前下动脉。显微镜检查显示PPHA的动脉粥样硬化改变，7个动脉瘤的真实动脉瘤样改变和所有动脉分叉处的图尼卡中膜缺损（Forbus内侧间隙），无早期动脉瘤样改变。
An autopsy case of persistent primitive hypoglossal artery (PPHA) with multiple cerebral aneurysms is reported. A 54-year-old man with subarachnoid hemorrhage was admitted to Kuwana Hospital three days after the onset. The patient was stuporous and had stiffness of the neck. A computed tomogram showed hematoma in the interhemispheric fissure, subarachnoid hemorrhage in the basal cisterns and bilateral Sylvian fissures, and maxked dilatation of ventricles. Cerebral angiogram revealed the left PPHA and multiple aneurysms at the right anterior cerebral artery (A 2) (ruptured), anterior communicating artery, left anterior cerebral artery (A 1), left internal carotid-anterior choroidal artery junction, right internal carotid artery (C 1), and right middle cerebral artery. Neck clipping of the ruptured aneurysm and ventricular drainage were performed on the day of admission. Eight days after admission he died of rupture of the residual aneurysm. In pathological study, the PPHA was originated from the extracranial portion of the left internal carotid artery, 2 cm distal from the cervical carotid bifurcation, entered the intracranial space through the hypoglossal foramen, and turned into the basilar artery. There were six aneurysms which were shown on cerebral angiogram and another aneurysm on the left anterior inferior cerebellar artery. Microscopic examination revealed atherosclerotic change of the PPHA, true aneurysmal changes of the seven aneurysms and defect of tunica media (Forbus' medial gap) at all of the arterial bifurcations without early aneurysmal changes.