若年者の嚢状脳動脈瘤

INTRACRANIAL SACCULAR ANEURYSMS IN THE FIRST THREE DECADES OF LIFE

I．はじめに

　嚢状脳動脈瘤の好発年齢は，40歳，50歳台をピークとして中高年齢層に多くみられ，若年者の発生頻度は少ないとされている。本論文では，自験例の頭蓋内根治手術を施行した嚢状脳動脈瘤のうち，30歳未満の症例を対象とし，若年者例の発生分布，臨床像，手術成績を検討し，その特徴を明らかにし，さらにその結果を，全症例と比較し，両者の相違について考察を加えた。

An analysis of surgically-treated 1,000 intracranial saccular aneurysms in our clinic during a period from June, 1961 to September, 1975, revealed 39 cases in patients under the age of 29 years. Some characteristics were emphasized in this studies. The sex incidence was male predominant, which exhibited a ratio of 4 to 1 for the ages below 20 years and 2.1 to 1 for the ages below 30 years. In sites distribution, there were striking incidence of aneurysms of the internal carotid termination, on the contrary, lower incidince of aneurysms of the middle cerebral artery, comparing with the cases in all ages.

The common complication of cerebral infarction secondary to the vasospasm associated with rupture of the aneurysm occured less often than in adults cases.

The surgical results of 39 cases in the first three decades of life, consisted of 29 excellent cases, 5 good, 4 poor and 1 death, have been as good or better than in the cases of all ages. Furthermore, the results of follow-up studies, which were obtained from 33 cases out of 38 survival cases, revealed 31 cases with full working and no deterioration.