椎骨動脈結紮術を施行した椎骨動脈瘤の1例

A CASE OF VERTEBRAL ANEURYSM WHICH RECEIVED LIGATION OF VERTEBRAL ARTERY

I．緒言

　椎骨動脈瘤の報告例は比較的少なく，中でも患者生存中にレントゲン撮影にて確認され，手術された例は非常に少ない。最近われわれは右椎骨動脈瘤に遭遇し，椎骨動脈結紮術を施行した1例を経験したので報告する。

A 48-year-old man, who about 2 months ago had had an attack of severe headache, stiffness of the neck, and difficulty of both standing and sitting, was admitted with complaints of gait disturbance, hemihy-pesthesia on the left side of body. Examinations revealed hypertention of 190/110 mmHg, ataxia (falling to the right), absence of wringing reflex on the right, hemihypesthesia (under C₂) on the left side of the body, diminished sense of taste at the posterior parts of the right side of the tongue and appearance of Gordon reflex on the right leg. E. M. G. showed di-minished N. M. U. and low voltage on the right gas-trocunemius muscle. Spinal fluid was almost normal. Right vertebral angiography disclosed a saccate aneu-rysm on the right vertebral artery above the posterior inferior cerebellar artery.

Ligation of right vertebral artery was performed at its turning point from the subclavian artery. After the operation hypesthesia, diminished sense of taste and gait disturbance were reduced, and 2 weeks later he left the hospital with satisfactory results and is now working in good spirits.