PDF(Pubmed)
Abstract：
In the field of cerebrovascular neurosurgery, intracranial aneurysms (IAs) have been occasionally associated with brain arteriovenous malformations (BAVMs), indicating a more aggressive clinical course, and increased rates of hemorrhage and rehemorrhage. Treatment of flow-related IAs in BAVMs remains debatable, with considerations for preventive intervention versus concurrent BAVM treatment. Managing such situations might be challenging, especially in determining which of the IAs or BAVMs should be treated first, and which treatment strategy would be most appropriate for each situation. A precise identification of the rupture site is required, whether it is the AVM nidus or the IA, for choosing the best treatment plans. We present a case of a 29-year-old male patient diagnosed with several intracranial vascular conditions: a ruptured anterior communicating artery (ACoA) aneurysm and an unruptured ophthalmic artery aneurysm, associated with a frontal BAVM. Moreover, we discussed the possible scenarios regarding the association of these conditions, highlighting their manifestations and the most suitable therapeutic approach for each. Thus, our exploration of the challenges and considerations involved in treating these intricate neurovascular conditions underscores the need for a customized approach for each patient\'s situation.
摘要：
在脑血管神经外科领域，颅内动脉瘤（IAs）偶尔与脑动静脉畸形（BAVM）有关，表明临床过程更具侵略性，出血和再出血率增加。BAVM中与流量相关的IAs的治疗仍有争议，考虑预防性干预与同步BAVM治疗。管理这种情况可能具有挑战性，特别是在确定应该首先处理哪一个IAs或BAVM时，以及哪种治疗策略最适合每种情况。需要精确识别破裂部位，无论是AVMNidus还是IA，选择最佳治疗方案。我们介绍了一例29岁的男性患者，被诊断患有多种颅内血管疾病：前交通动脉（ACoA）动脉瘤破裂和未破裂的眼动脉瘤，与额叶BAVM有关。此外，我们讨论了关于这些条件关联的可能情况，突出它们的表现和最合适的治疗方法。因此，我们对治疗这些复杂的神经血管疾病所涉及的挑战和考虑因素的探索强调,需要针对每个患者的情况采用定制的方法.
