PDF(Pubmed)
Abstract：
Modern neuroimaging methods do not completely rule out false diagnoses of intracranial aneurysms which can lead to an unwarranted operation associated with risks of complications. However, surgical interventions for falsely diagnosed aneurysms are quite rare. The purpose of this study is to demonstrate two clinical cases of false-positive aneurysms and a systematic review of the literature dedicated to the incidence and etiology of false-positive aneurysms, identifying risk factors associated with false-positive aneurysms. A literature search in two databases (PubMed and Web of Science) using keywords \"mimicking an intracranial aneurysm\", \"presenting as an intracranial aneurysm\", \"false positive intracranial aneurysms\", and \"neurosurgery\" was conducted. A total of 243 papers were found in the initial search in two databases. Sixteen papers (including 20 patients) were included in the final analysis. There were 10 women and 10 men. The most common location of false-positive aneurysms was the bifurcation of the middle cerebral artery (MCA). In the posterior circulation, false-positive aneurysms were identified either on the basilar artery, or at the vertebro-basilar junction. The main causes of false intracranial aneurysm diagnosis included artery occlusion with vascular stump formation, infundibular widening, fenestration, arterial dissection, contrast extravasation, and venous varix. In conclusion, summarizing the results of our analysis, we can say that surgical interventions for false-positive aneurysms are an underestimated problem in vascular neurosurgery. Despite extremely rare published clinical observations, the actual frequency of erroneous surgical interventions for false-positive aneurysms is unknown.
摘要：
现代神经影像学方法并不能完全排除颅内动脉瘤的误诊，这可能导致与并发症风险相关的不必要的手术。然而,错误诊断的动脉瘤的手术干预非常罕见。这项研究的目的是证明两个假阳性动脉瘤的临床病例，并对致力于假阳性动脉瘤的发生率和病因的文献进行系统回顾，确定与假阳性动脉瘤相关的危险因素。在两个数据库（PubMed和WebofScience）中使用关键字“模仿颅内动脉瘤”进行文献检索，“表现为颅内动脉瘤”，“颅内动脉瘤假阳性”，并进行了“神经外科手术”。在两个数据库中的初始搜索中共发现了243篇论文。最终分析包括16篇论文（包括20例患者）。有10个女人和10个男人。假阳性动脉瘤的最常见位置是大脑中动脉（MCA）的分叉。在后循环中，在基底动脉上发现了假阳性动脉瘤，或者在椎-基底交界处.颅内动脉瘤假性诊断的主要原因包括动脉闭塞伴血管残端形成，漏斗加宽，开窗术,动脉夹层,造影剂外渗,和静脉静脉曲张.总之,总结我们的分析结果，我们可以说，假阳性动脉瘤的手术干预在血管神经外科中是一个被低估的问题。尽管发表的临床观察非常罕见，对假阳性动脉瘤进行错误手术干预的实际频率未知.
