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Neurological Surgery No Shinkei Geka Volume 33, Issue 4 （April 2005）

Neurological Surgery 脳神経外科 33巻4号（2005年4月発行）

Japanese English

症例

対側動眼神経麻痺を呈した破裂内頸動脈瘤の1例 A Case Report of Ruptured Internal Carotid Artery Aneurysm with Contralateral Oculomotor Nerve Paresis 斉藤群大 ¹ , 太田原康成 ¹ , 小川彰 ² Gundai SAITO ¹ , Yasunari OTAWARA ¹ , Akira OGAWA ² ¹岩手県立千厩病院脳神経外科 ²岩手医科大学脳神経外科 ¹Department of Neurosurgery,Iwate Prefectural Senmaya Hospital ²Department of Neurosurgery,Iwate Medical University キーワード： internal carotid artery aneurysm , subarachnoid hemorrhage , contralateral oculmotor nerve paresis Keyword: internal carotid artery aneurysm , subarachnoid hemorrhage , contralateral oculmotor nerve paresis pp.365-368

発行日 2005年4月1日 Published Date 2005/4/1

DOI https://doi.org/10.11477/mf.1436100059

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Abstract 文献概要
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参考文献 Reference

Ⅰ．はじめに

　動眼神経麻痺を伴う脳動脈瘤としては内頸動脈瘤と脳底動脈瘤が知られている．この場合，動眼神経麻痺は通常動脈瘤と同側に生じる．今回われわれは，対側動眼神経麻痺を呈した破裂内頸動脈瘤の1例を経験したので文献的考察を加えて報告する．

We report a case of ruptured internal carotid artery aneurysm with contralateral oculomotor nerve paresis. A 69-years-old female experienced a sudden onset of severe headache. Left-sided mydriasis,absence of light reflex,disability of left ocular movement and ptosis were identified. Computed tomography scan revealed massive subarachnoid hemorrhage. Cerebral angiography showed a right internal carotid artery aneurysm. No abnormal finding was observed in the left internal carotid artery or basilar artery. Magnetic resonance imaging did not show thrombosed aneurysm. The oculomotor nerve paresis lasted for ten days. Ruptured right internal carotid artery aneurysm was surgically confirmed and repaired. We speculated that the contralateral oculomotor nerve paresis was the consequence of bloody jet flow from the ruptured aneurysm.