脳動脈瘤を伴つた内頸動脈欠損の1剖検例

AGENESIS OF THE INTERNAL CAROTID ARTERY WITH AN INTRACRANIAL ANEURYSM: REPORT OF A CASE

はじめに

　内頸動脈の欠損または形成不全の報告は比較的稀であり，文献上現在まで41例と思われ，本邦では竹内等^21），岡本等^18），東等^3）や半田等^8）の報告がある。この奇形は一側性または両側性であれ，その側副行路の形成により無症状に経過し得るものであるが，脳動脈瘤を合併することがあがり，重篤なクモ膜下出血のために不幸な転帰をとる例も少なくない。最近私達はクモ膜下出血にて発症し，脳血管写で前交通動脈瘤の外に右内頸動脈の欠損が証明され，剖検にて確認された症例を経験したので，文献的考察を行ない報告する。

A case of the agenesis of the right internal carotid artery with an intracranial aneurysm was herein reported in detail. The patient was a 65-year-old man who was admitted to our clinic after a severe subarachnoid hemorrhage on December 24, 1971. Four vessel serial angiograms revealed an aneurysm of the anterior communicating artery and an agenesis of the right internal carotid artery. The internal carotid artery was not demonstrated at the right side even by the serial aortography. He died on the 11 th hospital day and lacks of the right internal carotid artery and the right carotid canal were verified at autopsy.

41 cases of an agenesis or hypoplasia of the internal carotid artery have been reported on the literature up to now. It is of interest to know that 10 out of 41 cases have been associated with an intracranial aneurysm.