SLEに合併した後大脳動脈分枝末梢部破裂動脈瘤

Ruptured Aneurysm at the Peripheral Branch of the Posterior Cerebral Artery with Systemic Lupus Erythematosus

　後大脳動脈分枝末梢部に破裂脳動脈瘤を認めた73歳のSLE女性例を報告した。さらに本例を含め詳細な記述のあるSLEに破裂脳動脈瘤を併発した22例（動脈瘤43個）の特徴をまとめた。動脈瘤は主要動脈起始部に79.1％，末梢小動脈に20.9％発生した。fusiform様動脈瘤の発生率は30.2％と通常に比べ高い。死亡14例（63.6％），根治手術が可能であったのは11例（50％）でそのうちSLEによる合併症のために4例が死亡した。生存例の中にも経過中に重篤な合併症を引き起こすことが多く厳重な術後管理が必要と考えられた。

We report a 73-year-old woman with systemic lupus erythematosus (SLE) in whom intracerebral and intraventricular hemorrhage developed secon-dary to a ruptured aneurysm on the peripheral branch of the posterior cerebral artery. We revi-ewed data on 22 patients (43 aneurysms) in previous reports of ruptured cerebral aneurysms associated with SLE, including our case. Of these aneurysms, 34 (79.1%) were located on the major artery, and 9 (20.9%) were located on the peripheral small artery. Fusiform aneurysms accounted for 27.9% of the total. The prognosis was poor, and 14 patients (63.6%) died. Direct aneurysmal surgery was per-formed in 11 patients (50%), but 4 patients died of other diseases associated with SLE.