家族性地中海熱に併発し，頭蓋内出血で発症し，その後自然消退したレンズ核線条体動脈瘤の1例

Familial Mediterranean Fever-Associated Lenticulostriate Artery Aneurysm Presenting with Intracranial Hemorrhage and Disappearing Spontaneously: A Case Report

家族性地中海熱に併発した，レンズ核線条体動脈瘤の稀な1例を経験した。本症に対する外科的治療介入の必要性に関しても文献的考察を加え報告する。症例は家族性地中海熱にて加療中の45歳女性であり，突然の頭痛，めまいを発症し，右尾状核と側脳室内に出血を認めた。脳血管精査で内側レンズ核線条体動脈遠位部に紡錘状動脈瘤を認め，出血源と考えられた。慎重な経過観察にて，動脈瘤は経時的に縮小し，消退が確認された。

Abstract

Lenticulostriate artery (LSA) aneurysm is relatively rare, and the need for surgical intervention is controversial. Here, we report a case of ruptured LSA aneurysm which was accompanied by familial Mediterranean fever (FMF). A 45-year-old woman with a history of FMF presented with sudden onset of headache and vertigo. Computed tomography revealed hemorrhage in the right caudate nucleus and lateral ventricles. Digital subtraction angiography revealed a fusiform aneurysm (3mm) at the distal site of medial LSA. Observation was selected, and the aneurysm gradually decreased and eventually disappeared on the 105^th day from the onset. This was the first report describing an LSA aneurysm associated with FMF. It suggests that such aneurysms could be treated conservatively with close radiological follow-up.