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中华神经创伤外科电子杂志 ›› 2024, Vol. 10 ›› Issue (02) : 122 -125. doi: 10.3877/cma.j.issn.2095-9141.2024.02.011

病例报告

烟雾病合并血流相关性动脉瘤二例报道并文献复习
赖丽1, 尧小龙2, 李俊2,()   
  1. 1. 430056 武汉,江汉大学医学院
    2. 430033 武汉,江汉大学附属湖北省第三人民医院神经外科
  • 收稿日期:2023-12-22 出版日期:2024-04-15
  • 通信作者: 李俊

Moyamoya disease complicated with blood flow-related aneurysms: a report of 2 cases and literature review

Li Lai, Xiaolong Yao, Jun Li()   

  • Received:2023-12-22 Published:2024-04-15
  • Corresponding author: Jun Li
引用本文:

赖丽, 尧小龙, 李俊. 烟雾病合并血流相关性动脉瘤二例报道并文献复习[J/OL]. 中华神经创伤外科电子杂志, 2024, 10(02): 122-125.

Li Lai, Xiaolong Yao, Jun Li. Moyamoya disease complicated with blood flow-related aneurysms: a report of 2 cases and literature review[J/OL]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2024, 10(02): 122-125.

烟雾病(moyamoya disease,MMD)是以Willis环的主要分支血管发生严重狭窄或闭塞,并出现侧支循环代偿而形成颅底异常血管网的一种脑血管疾病,在脑血管造影图上形如"烟雾"状,故名为烟雾病[1]。MMD临床上分为缺血型和出血型,前者以儿童及青少年多见,后者以成年人多见;其中出血型MMD多为侧支血管或合并的动脉瘤破裂导致,常表现为脑实质及脑室出血[2]。MMD患者一旦出血,致残及致死风险极高,然而目前针对该疾病的诊断及治疗尚存争议。本文报道2例MMD合并血流相关性动脉瘤患者,结合相关文献分析该病的治疗方式。

图1 烟雾病合并远端血流相关性动脉瘤患者(病例1)术前术后影像学资料A:发病时颅脑CT示侧脑室旁出血破入脑室,蛛网膜下腔出血;B:DSA示烟雾样血管形成并发现血流相关性动脉瘤(红色圈);C:转入我院复查头部CT示出血较前明显吸收;D:次日复查DSA示相同位置处的动脉瘤未显影(红色圈)
Fig.1 Preoperative and postoperative imaging data of patients with moyamoya disease and distal flow-associated aneurysms (case 1)
图2 烟雾病合并烟雾血管型动脉瘤患者(病例2)术前术后影像学资料A:发病时颅脑CT示右侧基底节出血破入脑室,蛛网膜下腔出血;B:脑室钻孔引流术后CT图;C:术后DSA示烟雾状血管形成,右侧颈内动脉烟雾状血管分支发现动脉瘤(红色圈);D:出血后45 d复查DSA未见烟雾病合并血流相关性动脉瘤显影(红色圈)
Fig.2 Preoperative and postoperative imaging data of patients with moyamoya disease and moyamoya vascular aneurysm (case 2)
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