蝶形骨洞炎が波及したと思われた内頸動脈海綿静脈洞部細菌性脳動脈瘤の1症例

A Case of Bacterial Aneurysm of the Carotid Artery in the Cavernous Sinuses Portion Secondary to Sphenoid Sinusitis

　はじめに

　脳血管に発生した細菌性動脈瘤の中でも，内頸動脈海綿静脈洞部に発生したものは比較的稀とされている^1,2）。われわれは，蝶形骨洞炎に続発し海綿静脈洞症候群を呈し，脳血管撮影により同部の内頸動脈に動脈瘤を認め細菌性脳動脈瘤と診断した1例を経験したので報告する。

A 71-year-old man developed headache and left blepharoptosis. Computed tomography revealed ahigh density leasion in the sphenoid sinus and disten-sion of the left cavernous sinus.

He was then admitted to our hospital under the diagnosis of sphenoid sinusitis and cavernous sinusitis. After sphenoidectomy and chemotherapy and steroids, his symptoms were not improved. One month after admission, angiography revealed an aneurysm in the cavernous sinuses portion of the internal carotid artery. This aneurysm was thought to be a bacterial aneurysm due to sphenoid sinusitis.