- 期刊
Familial Intracranial Aneurysms
家族性顱內動脈瘤
摘要
我們提出一位53歲母親和她34歲之兒子皆因顱內動脈瘤破裂造成蜘蛛膜下腔出血及(或)腦內出血的家族病例。以電腦斷層攝影和腦血管攝影作為診斷動脈瘤之方法，雖然母親被送到本院急診時呈現昏迷狀態，兩例皆經手術治療及術後照顧而回復到原來之社會活動能力。根據文獻報告，家族性顱內動脈瘤傾向於年齡較輕時即破裂，且較常發生於內頸動脈和中大腦動脈而較少於前交通動脈。兄弟例之動脈瘤其發生於相同部位或對照部位且破裂於同一十年間的病例為一般病例之兩倍，顱內動脈瘤集中於同一家族內發生及以上之特徵可見先天性和遺傳對於某些家族性顱內動脈瘤之發生有其重大影響。我們對於家族性顱內動脈瘤其他成員之篩檢方式及未破裂動脈瘤之治療提出看法和討論。
關鍵字
無資料並列摘要
We describe a 53-year-old mother and a her 34-year-old son who suffered from spontaneous subarachnoid hemorrhage (SAH) and/or intracerebral hemorrhage due to a ruptured intracranial aneurysm. Diagnosis of the intracranial aneurysm was made by CT scan of the brain, and cerebral angiography. These two cases received surgical intervention and returned to their previous social activity after discharge, even though the mother had arrived in a comatose condition. The literature is reviewed and the characteristic expressions of familial intracranial aneurysms are described. The etiology of cerebral aneurysms is still uncertain but It Is likely multifactorial. For the 176 patients with intracranial aneurysm(s) treated at Kaohsiung Medial College Hospital, the mean age at diagnosis was 51.9 years and these aneurysms were distributed mainly at the internal carotid artery (43.8%) and the anterior communicating artery (33.5%). The familial aneurysms tend to rupture at a younger age, occur less often at the anterior communicating artery and more often at the internal carotid artery and the middle cerebral artery as compared with that of non-familial aneurysms. In siblings, aneurysms occur at identical sites or at mirror sites and rupture within the same decade of life twice as frequently as expected In non-familial aneurysm cases. The familial aggregation of intracranial aneurysms and the above characteristic expressions suggest that heredity may play a role in some familial aneurysms. The pattern of inheritance, however, has not been established. Screening examinations and the treatment of unruptured intracranial aneurysms in asymptomatic relatives of the familial cases are also discussed.