くも膜下出血で発症した解離性内頸動脈瘤の1例

Subarachnoid Hemorrhage Caused by a Dissecting Aneurysm of the Internal Carotid Artery ： Case Report and Review of the Literature

Ⅰ．はじめに

　頭蓋内の内頸動脈の解離性動脈瘤の報告は，診断技術が進んだ現在でも少ない．また，これらの多くは虚血症状で発症することが多く，くも膜下出血（subarachnoid hemorrhage，SAH）で発症する硬膜内内頸動脈の解離性動脈瘤の報告は稀である．

　われわれは，内頸動脈C1-2部に生じた頭蓋内解離性内頸動脈瘤を経験したので，若干の文献的考察を加えて報告する．

A case of subarachnoid hemorrhage (SAH) resulting from a ruptured intracranial dissecting aneurysm of the internal carotid artery (ICA) is reported. A 58-year-old woman presented with headache and vomiting. A CT showed diffuse SAH. A cerebral angiography demonstrated a dissecting aneurysm at the C2 segment of the right ICA. In the present case,trapping with STA-MCA anastomosis was performed and the postoperative course was uneventful. Postoperative follow-up cerebral angiogram detected no aneurysm. SAH caused by the rupture of a dissecting aneurysm of the ICA has been considered rare. To our knowledge,there have been only 29 cases. We discuss the clinical characteristics with a review of the literature.