Trombose espontânea de aneurisma gigante após extirpação de malformação vascular associada: relato de um caso

Niemeyer Filho, Paulo; Jahara, Felício; Laterman, Hélio

doi:10.1590/S0004-282X1983000300008

Resumos

É registrado o caso de um paciente que apresentava um aneurisma gigante da artéria cerebral média esquerda, e volumosa malformação vascular hemodinamicamente relacionada. Após extirpação da malformação vascular, houve desaparecimento espontâneo do aneurisma, conforme demonstrado em angio-grafias repetidas uma semana, seis meses e um ano após cirurgia. Atribuímos o fato à redução do fluxo sanguíneo regional cerebral, após a extirpação da malformação vascular, e a tendência natural desses aneurismas gigantes se trombosarem parcialmente.

A case of a patient with a giant aneurysm of the left middle cerebral artery and a huge arteriovenous malformation hemodinamically related is reported. Complete thrombosis of the aneurysm was observed after extirpation of the arteriovenous malformation as shown by angiography one week, six months and a year post-operatively. Reduction of the regional cebral blood flow after extirpation of the arteriovenous malformation and the natural tendency of these giant aneurysms to partially thrombose were to be the explanation for our result.

Trombose espontânea de aneurisma gigante após extirpação de malformação vascular associada: relato de um caso

Spontaneous thrombosis of a giant aneurysm after extirpation of a hemodinamically related arteriovenous malformation

Paulo Niemeyer Filho^I; Felício Jahara^II; Hélio Laterman^III

^IChefe de Clínica. Instituto de Neurocirurgia da Santa Casa do Rio de Janeiro (Diretor: Dr. Paulo Niemeyer)

^IIChefe do Departamento de Neurorradiologia. Instituto de Neurocirurgia da Santa Casa do Rio de Janeiro (Diretor: Dr. Paulo Niemeyer)

^IIIResidente de Neurocirurgia. Instituto de Neurocirurgia da Santa Casa do Rio de Janeiro (Diretor: Dr. Paulo Niemeyer)

RESUMO

É registrado o caso de um paciente que apresentava um aneurisma gigante da artéria cerebral média esquerda, e volumosa malformação vascular hemodinamicamente relacionada. Após extirpação da malformação vascular, houve desaparecimento espontâneo do aneurisma, conforme demonstrado em angio-grafias repetidas uma semana, seis meses e um ano após cirurgia. Atribuímos o fato à redução do fluxo sanguíneo regional cerebral, após a extirpação da malformação vascular, e a tendência natural desses aneurismas gigantes se trombosarem parcialmente.

SUMMARY

A case of a patient with a giant aneurysm of the left middle cerebral artery and a huge arteriovenous malformation hemodinamically related is reported. Complete thrombosis of the aneurysm was observed after extirpation of the arteriovenous malformation as shown by angiography one week, six months and a year post-operatively. Reduction of the regional cebral blood flow after extirpation of the arteriovenous malformation and the natural tendency of these giant aneurysms to partially thrombose were to be the explanation for our result.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Trabalho realizado no Instituto de Neurocirurgia da Santa Casa do Rio de Janeiro (Diretor: Dr. Paulo Niemeyer).

Instituto de Neurocirurgia da Santa Casa da Misericordia Rua Santa Luzia, 206 20.020 Rio de Janeiro, RJ Brasil.

1. AARABI, B. & CHAMBERS, J. Giant thrombosed aneurysm associated with an arteriovenous malformation : case report. J. Neurosurg. 49:278, 1978.
2. ADAMS, R. D. Case records of the Massachusetts General Hospital. Case 22. New Engl. J. Med. 268:724, 1963.
3. ALLCOCK, J. M. & CANHAM, P. B. Angiographic study of the growth of intracranial aneurysms. J. Neurosurg. 45:617, 1976.
4. ANDERSON, R. M. & BLACKWOOD, W. The association of arteriovenous angioma and saccular aneurysm of the arteries of the brain. J. Pathol. Bacteriol. 77:101, 1959.
5. ARAI, H.; SUGIYAMA, Y. & KAWAKAMI, S. Multiple intracranial aneurysms and vascular malformation in an infant: case report. J. Neurosurg. 37:357, 1972.
6. ARIETI, S. Sc GRAY, E. W. Progressive multiform angiosis: association of a cerebral angioma, aneurysms and other vascular changes in the brain. Arch. Neurol. Psych. (Chicago) 51:182, 1944.
7. BOYD-WILSON, J. S. The association of cerebral angiomas with intracranial aneurysms. J. Neurol. Neurosurg. Psychiat. 22:218, 1959.
8. CARLSON, D. H. & THOMSON, D Spontaneous thrombosis of a giant cerebral aneurysm in five days: report of a case. Neurol. (Minneapolis) 26:334, 1976.
9. CHASON, J. L. & HINDMAN, W. M. Berry aneurysms of the circle of Willis: results of a planned autopsy study. Neurol. (Minneapolis) 8:41, 1958.
10. CRONQVIST, S.; GRANHOLM, L. & LUNDSTROM, N. R. Hydrocephalus and congestive heart failure caused by intracranial arteriovenous malformations in infants. J. Neurosurg. 36:249, 1972.
11. DRAKE, C. G. Giant intracranial aneurysms: experience with surgical treatment in 174 patients. Clin. Neurosurg. 26:12, 1979.
12. DRAKE, C. G. Cerebral arteriovenous malformations : considerations for and experience with surgical treatment in 166 cases. Clin. Neurosurg. 26:145, 1979.
13. FINE, R.; PATERSON, A.; LESLIE, S. & GAYLOR, J. B. Simultaneous occurrence of intracranial aneurysm and arteriovenous malformation: report of a case successfully treated. Brit. med. J. 2:711, 1960.
14. HAGGENDAHL, E. ; INGUAR, D. H. & LASSEN, N. A. Pre and postoperative measurements of regional cerebral blood flow in three cases of intracranial arteriovenous aneurysms. J. Neurosurg. 22:1, 1965.
15. HASHIMOTO, N.; HANDA, H. & NAGATA, I. Experimentally induced cerebral aneurysms in rats: relation of hemodynamics in the circle of Willis to formation of aneurysms. Surg. Neurol. 13:41, 1980.
16. HAYASHI, S.; ARIMOTO. T.; ITAKURA, T.; FUJII, T.; NISHIGUCHI, T. & KOMAI, N. The association of intracranial aneurysms and arteriovenous malformation of the brain: case report. J. Neurosurg. 55:971, 1981.
17. HIGASHI, K.; HATANO, M.; YAMASHITA, T.; ÍNOUE, S. & MATSUMURA, T. Coexistance of posterior inferior cerebellar artery aneurysm and arteriovenous malformation fed by the same artery. Surg. Neurol. 12:405, 1979.
18. MORLEY, T. P. & BARR, H. W. K. Giant intracranial aneurysms: diagnosis, course, and management. Clin. Neurosurg. 16:73, 1968.
19. NIEMEYER, P. & AKERMANN, A. Diagnóstico e tratamento cirúrgico dos aneurismas arteriovenosos do cerebro. Med. Cirurg. Farm. (Rio de Janeiro) 204:111, 1953.
20. ONUMA, T. & SUZUKI, J. Surgical treatment of giant intracranial aneurysms. J. Neurosurg. 51:33, 1979.
21. PARKINSON, D. & BACHERS, G. Arteriovenous malformation: summary of 100 consecutive supratentorial cases. J. Neurosurg. 53:285, 1980.
22. PATERSON, J. H. & McKISSOCH, W. A clinical survey of intracranial angiomas with special reference to their mode of progression and surgical treatment: a report of 110 cases. Brain 79:233, 1956.
23. SHENKIN, H. A.; JENKINS, F. & KIM, K. Arteriovenous anomaly of the brain associated with cerebral aneurysm: case report. J. Neuros' rg. 34:225, 1971.
24. SOMACH, F. M. & SHENKIN, H. A. Angiographic end-results of carotid ligation in the treatment of carodit aneurysm. J. Neurosurg. 24:966, 1966.
25. SUTHERLAND, G. R.; KING, M. E.; PEERLESS, S. J.; VEZINA, W. C; BROWN, G. W. & CHAMBERLAIN, M. J. Platelet interaction within giant intracranial aneurysms. J. Neurosurg. 56:53, 1982.

Datas de Publicação

Publicação nesta coleção
14 Ago 2012
Data do Fascículo
Set 1983

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. AARABI, B. & CHAMBERS, J. Giant thrombosed aneurysm associated with an arteriovenous malformation : case report. J. Neurosurg. 49:278, 1978.

[2] 2. ADAMS, R. D. Case records of the Massachusetts General Hospital. Case 22. New Engl. J. Med. 268:724, 1963.

[3] 3. ALLCOCK, J. M. & CANHAM, P. B. Angiographic study of the growth of intracranial aneurysms. J. Neurosurg. 45:617, 1976.

[4] 4. ANDERSON, R. M. & BLACKWOOD, W. The association of arteriovenous angioma and saccular aneurysm of the arteries of the brain. J. Pathol. Bacteriol. 77:101, 1959.

[5] 5. ARAI, H.; SUGIYAMA, Y. & KAWAKAMI, S. Multiple intracranial aneurysms and vascular malformation in an infant: case report. J. Neurosurg. 37:357, 1972.

[6] 6. ARIETI, S. Sc GRAY, E. W. Progressive multiform angiosis: association of a cerebral angioma, aneurysms and other vascular changes in the brain. Arch. Neurol. Psych. (Chicago) 51:182, 1944.

[7] 7. BOYD-WILSON, J. S. The association of cerebral angiomas with intracranial aneurysms. J. Neurol. Neurosurg. Psychiat. 22:218, 1959.

[8] 8. CARLSON, D. H. & THOMSON, D Spontaneous thrombosis of a giant cerebral aneurysm in five days: report of a case. Neurol. (Minneapolis) 26:334, 1976.

[9] 9. CHASON, J. L. & HINDMAN, W. M. Berry aneurysms of the circle of Willis: results of a planned autopsy study. Neurol. (Minneapolis) 8:41, 1958.

[10] 10. CRONQVIST, S.; GRANHOLM, L. & LUNDSTROM, N. R. Hydrocephalus and congestive heart failure caused by intracranial arteriovenous malformations in infants. J. Neurosurg. 36:249, 1972.

[11] 11. DRAKE, C. G. Giant intracranial aneurysms: experience with surgical treatment in 174 patients. Clin. Neurosurg. 26:12, 1979.

[12] 12. DRAKE, C. G. Cerebral arteriovenous malformations : considerations for and experience with surgical treatment in 166 cases. Clin. Neurosurg. 26:145, 1979.

[13] 13. FINE, R.; PATERSON, A.; LESLIE, S. & GAYLOR, J. B. Simultaneous occurrence of intracranial aneurysm and arteriovenous malformation: report of a case successfully treated. Brit. med. J. 2:711, 1960.

[14] 14. HAGGENDAHL, E. ; INGUAR, D. H. & LASSEN, N. A. Pre and postoperative measurements of regional cerebral blood flow in three cases of intracranial arteriovenous aneurysms. J. Neurosurg. 22:1, 1965.

[15] 15. HASHIMOTO, N.; HANDA, H. & NAGATA, I. Experimentally induced cerebral aneurysms in rats: relation of hemodynamics in the circle of Willis to formation of aneurysms. Surg. Neurol. 13:41, 1980.

[16] 16. HAYASHI, S.; ARIMOTO. T.; ITAKURA, T.; FUJII, T.; NISHIGUCHI, T. & KOMAI, N. The association of intracranial aneurysms and arteriovenous malformation of the brain: case report. J. Neurosurg. 55:971, 1981.

[17] 17. HIGASHI, K.; HATANO, M.; YAMASHITA, T.; ÍNOUE, S. & MATSUMURA, T. Coexistance of posterior inferior cerebellar artery aneurysm and arteriovenous malformation fed by the same artery. Surg. Neurol. 12:405, 1979.

[18] 18. MORLEY, T. P. & BARR, H. W. K. Giant intracranial aneurysms: diagnosis, course, and management. Clin. Neurosurg. 16:73, 1968.

[19] 19. NIEMEYER, P. & AKERMANN, A. Diagnóstico e tratamento cirúrgico dos aneurismas arteriovenosos do cerebro. Med. Cirurg. Farm. (Rio de Janeiro) 204:111, 1953.

[20] 20. ONUMA, T. & SUZUKI, J. Surgical treatment of giant intracranial aneurysms. J. Neurosurg. 51:33, 1979.

[21] 21. PARKINSON, D. & BACHERS, G. Arteriovenous malformation: summary of 100 consecutive supratentorial cases. J. Neurosurg. 53:285, 1980.

[22] 22. PATERSON, J. H. & McKISSOCH, W. A clinical survey of intracranial angiomas with special reference to their mode of progression and surgical treatment: a report of 110 cases. Brain 79:233, 1956.

[23] 23. SHENKIN, H. A.; JENKINS, F. & KIM, K. Arteriovenous anomaly of the brain associated with cerebral aneurysm: case report. J. Neuros' rg. 34:225, 1971.

[24] 24. SOMACH, F. M. & SHENKIN, H. A. Angiographic end-results of carotid ligation in the treatment of carodit aneurysm. J. Neurosurg. 24:966, 1966.

[25] 25. SUTHERLAND, G. R.; KING, M. E.; PEERLESS, S. J.; VEZINA, W. C; BROWN, G. W. & CHAMBERLAIN, M. J. Platelet interaction within giant intracranial aneurysms. J. Neurosurg. 56:53, 1982.