发生在筛前动脉颅内分支的动脉瘤是非常罕见的,复习文献仅有一例报道,此病例由于血液动力学因素导致丰富的血流经吻合血管流经眼动脉。作者报告1例少见的来自筛前动脉的巨大动脉瘤,无高血压病史及血液动力学因素,以颅内出血就诊。 患者女性,45岁,入院前1天突感头痛,继之意识丧失2h,之后出现感觉障碍及尿失禁。既往无类似发作史,无发热、外伤、糖尿病和高血压病史。查体:血压14.7/9.3kPa,自动睁眼,双侧瞳孔3mm,光反射灵敏,四肢运动自如,语言表达连贯,但嗜睡,右侧中枢性面瘫,右侧肢体轻度偏瘫,颈抵抗感明显,Kernig征阳性,血液化验正常,CT扫描显示左额极脑内血肿及邻近部位硬膜下血肿,强化扫描显示左眶额部密度增高,提示一个血管性病变,左侧颈 Aneurysms that occur in the intracranial branches of the anterior ethmoidal artery are rare, with only one review of the literature, where hemodynamics lead to abundant blood flow through the ophthalmic artery through the anastomotic vessel. The authors report a rare case of a giant aneurysm from the anterior ethmoidal artery, with no history of hypertension and hemodynamic factors and treatment with intracranial hemorrhage. Female, 45 years old, with sudden headache and headache 1 day before admission, followed by loss of consciousness for 2 hours followed by sensory disturbances and urinary incontinence. No previous history of similar attacks, no fever, trauma, diabetes and hypertension history. Examination: blood pressure 14.7 / 9.3kPa, eyes open automatically, bilateral pupil 3mm, sensitive to light reflexes, limbs movement freely, the language expression is consistent, but drowsiness, the right side of the central paralysis, right hemiplegia mild limbs obvious neck resistance , Kernig sign positive, normal blood test, CT scan shows the left frontal encephalic hematoma and adjacent sites of subdural hematoma, enhanced scan showed elevated left orbit volume, suggesting a vascular lesion, the left neck