PDF(Pubmed)
Abstract：
Background Patients with neurofibromatosis type 1 (NF1) have various vascular diseases due to the vascular fragility, but no reports of case of giant thrombotic aneurysm was found. We treated a rare case of giant thrombotic aneurysm of the internal carotid artery (ICA) in a patient with NF1. Case Presentation A 60-year-old man had suffered deteriorating visual loss and homonymous hemianopia. Contrast-enhanced computed tomography showed a giant thrombosed aneurysm on the anterior wall of the ICA located in the optic chiasma. We planned and completed the external carotid artery-middle cerebral artery high-flow bypass using radial artery graft. The visual fields test was performed 14 days after surgery. Homonymous hemianopia persisted but no exacerbation of visual field impairment was observed. No complications were found at 14 days after surgery and the postoperative course was uneventful. Conclusion We consider that external carotid artery-middle cerebral artery bypass surgery using radial artery grafts is a safe and effective treatment method for giant thrombotic aneurysm associated with NF1.
摘要：
背景1型神经纤维瘤病（NF1）患者由于血管脆性而有多种血管疾病，但没有发现巨大血栓性动脉瘤病例的报告。我们在NF1患者中治疗了罕见的颈内动脉（ICA）巨大血栓性动脉瘤病例。病例介绍一名60岁的男子视力丧失和同义偏盲恶化。对比增强计算机断层扫描显示，位于视神经交叉中的ICA前壁有一个巨大的血栓形成的动脉瘤。我们计划并完成了使用桡动脉移植物的颈外动脉-大脑中动脉高流量旁路。手术后14天进行视野测试。同源偏盲持续存在，但未观察到视野损害的恶化。术后14天未发现并发症，术后进展顺利。结论颈外动脉-大脑中动脉搭桥术是治疗NF1合并巨大血栓性动脉瘤安全有效的方法。
