末梢性上小脳動脈解離性動脈瘤破裂を血管内手術にて治療した1例

A Case of Ruptured Superior Cerebellar Artery Dissection Treated by Endovascular Embolization

はじめに

　解離性脳動脈瘤（以下DA）は本疾患に対する関心の高まり，および診断技術の進歩により，報告数が増加しつつある^1，2）。しかし後頭蓋窩において椎骨・脳底動脈以外の末梢部に発生したDAの報告は少なく^3－5），特に上小脳動脈（以下SCA）に限局発生し血管内手術によって治療した症例は本報告1例のみである^6）。今回，われわれはくも膜下出血（以下SAH）で発症した末梢性上小脳動脈解離性動脈瘤に対し，血管内手術を行い，良好な結果を得たので報告する。

Abstract

　The authors herein report a case of a ruptured dissection of the superior cerebellar artery (SCA). A 68-year-old man presented with symptons of sudden headache and nausea. The CT scan revealed the presence of both a subarachnoid hemorrhage (SAH) and acute hydrocephalus. The left vertebral angiogram showed an fusiform dilatation in the cerebellomesencephalic segment of the left SCA. Endovascular embolization of the aneurysm and SCA was successfully performed using Guglielmi detachable coils (GDCs). No delayed ischemic deficits were observed after the treatment. A dissection of the distal segment of the SCA is a very rare occurrence. We believe endovascular embolization using GDCs to be an effective and less invasive therapy for the treatment of an SCA dissection with SAH.