動脈瘤塞栓術後に脳血管攣縮を来した未破裂内頚動脈瘤の1例

Cerebral Vasospasm after Coil Embolization for Unruptured Internal Carotid Artery Aneurysm: Case Report

Ⅰ．はじめに

　脳血管攣縮の多くは，くも膜下出血発症後4～14日の間に生じ，くも膜下出血患者の予後を左右する重大な病態であり，その治療にはしばしば難渋する．脳血管攣縮の原因としては血液分解産物が血管壁に作用して生じるとされている．今回われわれは，未破裂動脈瘤の塞栓術後に広範囲な無症候性脳血管攣縮を生じた1例を経験したので，若干の文献的考察を加え報告する．

　A 38-year-old woman was admitted to our hospital with a 3-day history of severe headache associated with some nausea and vomiting. MRI did not show any evidence of subarachnoid hemorrhage,but MRA and CTA showed an aneurysm on the paraclinoid region of the right internal carotid artery. She was successfully treated by coil embolization. MRA taken 7 days after the treatment showed marked vasospam. Fortunately,her therapeutic course was uneventful and she was discharged without any neurological deficits. Vasospasm without subarachnoid hemorrhage is a rare event. Here,we review the literature and discuss potential mechanisms for vasospasm in the absence of subarachnoid hemorrhage.