Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/S1677-54492005000300013
Jornal Vascular Brasileiro
Case report

Aneurisma da artéria vertebral extracraniana em puérpera portadora de neurofibromatose clássica

Carla Aparecida Faccio Bosnardo; Rodrigo Machado Landim; Ana Terezinha Guillaumon; Marcus Ageu Baptista; Ricardo Henklain

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Resumo

Paciente de 26 anos, no 10º dia de puerpério, apresentou dor súbita em região cervical esquerda irradiada para região supraclavicular do mesmo lado, seguida de aparecimento de massa pulsátil. Relatava hipertensão sistólica média de 160 mmHg, e diastólica média de 130 mmHg na gravidez e neurofibromatose. Ao exame físico, apresentava massa pulsátil em região supraclavicular esquerda, sem frêmitos e/ou sopros. Um alargamento do mediastino foi detectado através de raio-x de tórax. Uma tomografia computadorizada (região cervical e torácica) evidenciou tumoração em território de artéria subclávia esquerda na sua porção proximal, sem limites definidos pelo extravasamento de contraste, além de hemotórax gigante à esquerda. A paciente evoluiu com choque hipovolêmico, sendo submetida à cirurgia de urgência, com toracotomia seguida de cervicotomia, onde se evidenciou lesão aneurismática rota da artéria vertebral esquerda logo após sua emergência. Após controle do sangramento, procedeu-se à sua ligadura. A paciente evoluiu satisfatoriamente, estando em acompanhamento ambulatorial.

Palavras-chave

neurofibromatose, aneurisma, artéria vertebral

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