PDF(Pubmed)
Abstract：
Perianeurysmal cysts are a rare and poorly understood finding in patients both with treated and untreated aneurysms. While the prior literature suggests that a minority of perianeurysmal cysts develop 1-4 years following endovascular aneurysm treatment, this updated review demonstrates that nearly half of perianeurysmal cysts were diagnosed following aneurysm coiling, with the other half diagnosed concurrently with an associated aneurysm prior to treatment. 64% of perianeurysmal cysts were surgically decompressed, with a 39% rate of recurrence requiring re-operation. We report a case of a 71-year-old woman who presented with vertigo and nausea and was found to have a 3.4 cm perianeurysmal cyst 20 years after initial endovascular coiling of a ruptured giant ophthalmic aneurysm. The cyst was treated with endoscopic fenestration followed by open fenestration upon recurrence. The case represents the longest latency from initial aneurysm treatment to cyst diagnosis reported in the literature and indicates that the diagnosis of perianeurysmal cyst should remain on the differential even decades after treatment. Based on a case discussion and updated literature review, this report highlights proposed etiologies of development and management strategies for a challenging lesion.
摘要：
在治疗和未治疗的动脉瘤患者中，动脉瘤周围囊肿是一种罕见且鲜为人知的发现。虽然先前的文献表明，少数动脉瘤周围囊肿在血管内动脉瘤治疗后1-4年发展，这项最新的综述表明，近一半的动脉瘤周围囊肿被诊断为动脉瘤盘绕后，另一半在治疗前同时诊断为相关动脉瘤。64%的动脉瘤周围囊肿经手术减压,39%的复发率需要再次手术。我们报告了一例71岁的妇女，该妇女出现眩晕和恶心，在破裂的巨大眼动脉瘤的最初血管内盘绕20年后被发现有3.4厘米的动脉瘤周围囊肿。囊肿经内镜开窗术治疗，复发后再开窗术。该病例代表了文献中报道的从初始动脉瘤治疗到囊肿诊断的最长潜伏期，并表明动脉瘤周围囊肿的诊断应在治疗后数十年仍保持鉴别。在案例讨论和最新文献综述的基础上，本报告重点介绍了针对具有挑战性的病变的发展病因和管理策略.
