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大脑前动脉水平部(A_1)脑动脉瘤非常少见,占全脑动脉瘤的1.3～1.5%。而在A_1段发生多发性动脉瘤者,到目前尚未见有报告。本文报告一例在A_1段发生的二个动脉瘤,其中一个动脉瘤发生在由于A_1发生纽曲而形成弧形突起的顶端,未见有穿通支的分支。结合本例对脑动脉瘤发生的部位及动脉纽曲的意义进行讨论。患者62岁,女性。因突然头痛、呕吐伴颈强直入院。检查:意识清楚,答话正确,颈项强直,无偏瘫。CT显示基底池高密度区。右颈内动脉造影正位像:A_1纽曲向上突起呈弧形曲线,其顶端见一动脉瘤,颈内动脉,A_1分叉部见一动脉瘤。左颈内动脉造影正位像:通过前交通动脉可见两个动脉瘤。通过后颈内动脉造影斜位片,两个动脉瘤的位置显得更清楚。于病后第九天行右额颞部开颅术,在颈内动脉,A_1分叉部见一动脉瘤,
Cerebral aneurysms at the level of the anterior cerebral artery (A_1) are rare and account for 1.3 to 1.5% of total cerebral aneurysms. However, there have been no reports of multiple aneurysms in the A1 segment. This article reports one case of two aneurysms that occurred in the A_1 segment. One of the aneurysms occurred at the tip of a curved protrusion due to buckling of A_1, and no branch of the perforating branch was observed. Combined with this example, the significance of the site of cerebral aneurysm and the significance of arterial buckling is discussed. The patient is 62 years old and female. Sudden headache, vomiting and neck stiffness were admitted to the hospital. Check: Consciousness is clear, answer is correct, neck stiffness, no bias. CT shows a high density zone in the basement pool. Right carotid artery angiography right image: A_1 nubuck curved upward curve, the top see an aneurysm, internal carotid artery, A_1 bifurcation see an aneurysm. Left carotid artery angiography right image: Two aneurysms can be seen through the anterior communicating artery. Through the posterior internal carotid artery angiogram, the position of the two aneurysms became clearer. On the ninth day after the illness, a craniotomy of the right frontotemporal region was performed. In the internal carotid artery, an aneurysm was seen in the A_1 bifurcation.