neurosurgeryНейрохирургияRussian journal of neurosurgery1683-32952587-7569Издательский дом "МедИНК"10.63769/1683-3295-2016-0-2-59-62neurosurgery-289Research ArticleНАБЛЮДЕНИЕ ИЗ ПРАКТИКИFROM PRACTICEСПОНТАННОЕ ТРОМБИРОВАНИЕ ДИСТАЛЬНОЙ АНЕВРИЗМЫ ВЕРХНЕЙ МОЗЖЕЧКОВОЙ АРТЕРИИThe spontaneous thrombosis of distal aneurysm of superior cerebellar arteryКолотвиновВладимир СергеевичKolotvinovV. S.kolotvinov@gkb40.ur.ruМарченкоОльга ВикторовнаMarchenkoO. V.noemail@neicon.ruЦориевАндрей ЭльдаровичTsorievA. E.noemail@neicon.ruСтраховАндрей АлександровичStrakhovA. A.noemail@neicon.ruОшурковПавел АлександровичOshurkovP. A.noemail@neicon.ruУлицкийИлья РомановичUlitskiiI. R.noemail@neicon.ruМАУ «Городская клиническая больница №40»; ГБОУ ВПО УГМУRussian Federation201605102017025962Copyright © Колотвинов В.С., Марченко О.В., Цориев А.Э., Страхов А.А., Ошурков П.А., Улицкий И.Р., 20172017Колотвинов В.С., Марченко О.В., Цориев А.Э., Страхов А.А., Ошурков П.А., Улицкий И.Р.Kolotvinov V.S., Marchenko O.V., Tsoriev A.E., Strakhov A.A., Oshurkov P.A., Ulitskii I.R.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.therjn.com/jour/article/view/289

Цель исследования. Обзор данных литературы и анализ тактики лечения пациента с дистальной аневризмой ВМА. Материалы и методы. Проведен обзор данных литературы и клиническое наблюдение пациента с аневризмой ВМА (анализ медицинской документации с проспективным наблюдением за пациентом). Результаты. У пациента в остром периоде субарахноидального кровоизлияния по данным церебральной ангиографии (ЦАГ) верифицирована дистальная фузиформная аневризма ВМА, через 3 мес отмечено увеличение аневризмы в размерах. Во время МР-ангиографии пациент перенес приступ головокружения, после чего по данным МРТ и ЦАГ верифицировано тотальное тромбирование аневризмы и несущего сосуда. На контрольной ЦАГ через 1 год данных за реканализацию артерии и аневризмы левой ВМА не получено. Клинически - неврологического дефицита нет. Заключение. В отношении дистальных аневризм ВМА консервативная тактика может стать альтернативой открытой и эндоваскулярной хирургии, сопряженной с рисками ишемических осложнений при треппинге несущей артерии.

The distal aneurysms of superior cerebellar artery (SCA) are very rare pathology with no clear recommendations concerning treatment strategy. Objective: to present the clinical case and literature review concerning distal aneurysms of SCA. Material and methods. The review of literature was conducted and clinical observation with follow-up of patient with distal aneurysm of SCA was performed. Results. The distal fusiform aneurysm of SCA was verified according to the data of digital subtraction angiography (DSA) in patient with acute subarachnoid hemorrhage with following aneurysm enlargement in 3 months. This patient once suffered from acute vertigo during MRA procedure. The following MRA and DSA procedures revealed total thrombosis of aneurysm and parent artery. The control DSA in 1 year showed no signs if aneurysm and left SCA refilling. Patient had no neurological deficit. Conclusion. The conservative treatment for distal SCA aneurysms may be as effective as microsurgical and endovascular treatment which can result in ischemic damages in case of surgical trapping of parent artery.

верхняя мозжечковая артерияспонтанное тромбирование аневризмыдистальные аневризмыsuperior cerebellar arteryspontaneous thrombosis of aneurysmdistal aneurysmReferencesBlack S.P., German W.J. Observations on the relationship between the volume and the size of the orifice of experimental aneurysms //Journal of neurosurgery. - 1960. - V. 17. - P. 984-990.Black S.P., German W.J. Observations on the relationship between the volume and the size of the orifice of experimental aneurysms //Journal of neurosurgery. - 1960. - V. 17. - P. 984-990.Cantore G., Santoro A., Da Pian R. Spontaneous occlusion of supraclinoid aneurysms after the creation of extraintracranial bypasses using long grafts: report of two cases // Neurosurgery. - 1999. - V. 44. - №. 1. - P. 216-219.Cantore G., Santoro A., Da Pian R. Spontaneous occlusion of supraclinoid aneurysms after the creation of extraintracranial bypasses using long grafts: report of two cases // Neurosurgery. - 1999. - V. 44. - №. 1. - P. 216-219.Carlson D.H., Thomson D. Spontaneous thrombosis of a giant cerebral aneurysm in five days Report of a case // Neurology. - 1976. - V. 26. - №. 4. - P. 334-334.Carlson D.H., Thomson D. Spontaneous thrombosis of a giant cerebral aneurysm in five days Report of a case // Neurology. - 1976. - V. 26. - №. 4. - P. 334-334.Danet M., Raymond J., Roy D. Distal superior cerebellar artery aneurysm presenting with cerebellar infarction: report of two cases //American journal of neuroradiology. - 2001. - V. 22. - №. 4. - P. 717-720.Danet M., Raymond J., Roy D. Distal superior cerebellar artery aneurysm presenting with cerebellar infarction: report of two cases //American journal of neuroradiology. - 2001. - V. 22. - №. 4. - P. 717-720.Krings T., Choi I. S. The many faces of intracranial arterial dissections //Interventional Neuroradiology. - 2010. - V. 16. - №. 2. - P. 151-160.Krings T., Choi I. S. The many faces of intracranial arterial dissections //Interventional Neuroradiology. - 2010. - V. 16. - №. 2. - P. 151-160.Matricali B., Seminara P. Aneurysm Arising from the Medical Branch of the Superior Cerebellar Artery //Neurosurgery. - 1986. - V. 18. - №. 3. - P. 350-352.Matricali B., Seminara P. Aneurysm Arising from the Medical Branch of the Superior Cerebellar Artery //Neurosurgery. - 1986. - V. 18. - №. 3. - P. 350-352.Kang M.C. et al. Coil Embolization of Ruptured Thrombosed Distal Superior Cerebellar Artery Aneurysm: A Case Report // Journal of cerebrovascular and endovascular neurosurgery. - 2012. - V. 14. - №. 3. - P. 243-246.Kang M.C. et al. Coil Embolization of Ruptured Thrombosed Distal Superior Cerebellar Artery Aneurysm: A Case Report // Journal of cerebrovascular and endovascular neurosurgery. - 2012. - V. 14. - №. 3. - P. 243-246.Nakau H. et al. Acute disappearance of ruptured aneurysm located near the origin of the superior cerebellar artery-case report //Neurologia medico-chirurgica. - 2007. - V. 47. - №. 10. - P. 468-470.Nakau H. et al. Acute disappearance of ruptured aneurysm located near the origin of the superior cerebellar artery-case report //Neurologia medico-chirurgica. - 2007. - V. 47. - №. 10. - P. 468-470.Nussbaum E.S. et al. Dissecting peripheral superior cerebellar artery aneurysms: Report of two cases and review of the literature //Surgical neurology international. - 2011. - V. 2.Nussbaum E.S. et al. Dissecting peripheral superior cerebellar artery aneurysms: Report of two cases and review of the literature //Surgical neurology international. - 2011. - V. 2.Ohta H. et al. Spontaneous total thrombosis of distal superior cerebellar artery aneurysm //Acta neurochirurgica. - 2001. - V. 143. - №. 8. - P. 837-843.Ohta H. et al. Spontaneous total thrombosis of distal superior cerebellar artery aneurysm //Acta neurochirurgica. - 2001. - V. 143. - №. 8. - P. 837-843.Peluso J.P.P. et al. Superior cerebellar artery aneurysms: incidence, clinical presentation and midterm outcome of endovascular treatment //Neuroradiology. - 2007. - V. 49. - №. 9. - P. 747-751.Peluso J.P.P. et al. Superior cerebellar artery aneurysms: incidence, clinical presentation and midterm outcome of endovascular treatment //Neuroradiology. - 2007. - V. 49. - №. 9. - P. 747-751.Pozzati E., Tognetti F., Padovani R. et al. Superior cerebellar artery aneurysms. // J Neurosurg Sci. - 1980. - V. 24. - P. 85-88.24.Pozzati E., Tognetti F., Padovani R. et al. Superior cerebellar artery aneurysms. // J Neurosurg Sci. - 1980. - V. 24. - P. 85-88.24.Rodraguez-Herrôndez A. et al. Distal aneurysms of intracranial arteries: application of numerical nomenclature, predilection for cerebellar arteries, and results of surgical management //World neurosurgery. - 2013. - V. 80. - №. 1. - P. 103-112.Rodraguez-Herrôndez A. et al. Distal aneurysms of intracranial arteries: application of numerical nomenclature, predilection for cerebellar arteries, and results of surgical management //World neurosurgery. - 2013. - V. 80. - №. 1. - P. 103-112.Sherman D.G., Salmon J.H. Ocular bobbing with superior cerebellar artery aneurysm: case report //Journal of neurosurgery. - 1977. - V. 47. - №. 4. - P. 596-598.Sherman D.G., Salmon J.H. Ocular bobbing with superior cerebellar artery aneurysm: case report //Journal of neurosurgery. - 1977. - V. 47. - №. 4. - P. 596-598.Whittle I.R., Dorsch N.W., Besser M. Spontaneous thrombosis in giant intracranial aneurysms //Journal of Neurology, Neurosurgery & Psychiatry. - 1982. - V. 45. - №. 11. - P. 1040-1047.Whittle I.R., Dorsch N.W., Besser M. Spontaneous thrombosis in giant intracranial aneurysms //Journal of Neurology, Neurosurgery & Psychiatry. - 1982. - V. 45. - №. 11. - P. 1040-1047.Whittle I.R. et al. Spontaneous thrombosis of a giant intracranial aneurysm and ipsilateral internal carotid artery: case report //Journal of neurosurgery. - 1982. - V. 56. - №. 2. - P. 287-289.Whittle I.R. et al. Spontaneous thrombosis of a giant intracranial aneurysm and ipsilateral internal carotid artery: case report //Journal of neurosurgery. - 1982. - V. 56. - №. 2. - P. 287-289.

The authors declare that there are no conflicts of interest present.