上小脳動脈動脈瘤に対する治療：clippingおよびcoilingの2例報告

Surgical and Endovascular Treatment for Superior Cerebellar Artery Aneurysms: Report of Two Cases

Ⅰ．はじめに

　後頭蓋窩動脈瘤のうち，上小脳動脈にみられる動脈瘤は稀であり，その解剖学的特性から手術方法や手術手技に関しても議論の分かれるところである．今回われわれは，同部の破裂動脈瘤に対し直達手術を施行した1例，動脈瘤末梢部の虚血症状にて発症した未破裂動脈瘤に対し脳血管内手術を施行した1例の，計2症例を経験したので文献的考察を加えて報告する．

　Aneurysms located on the superior cerebellar artery（SCA）are uncommon and their presentation, natural history, and clinical management are poorly understood. Reports related to the endovascular or surgical management of SCA aneurysms are rare. Herein, we report two cases of SCA aneurysm. The first is that of a 70-year-old woman who presented with subarachnoid hemorrhage（SAH). Surgical treatment（neck clipping）of the ruptured SCA aneurysm was performed, and the flow of the parent artery disappeared. The second is that of a 69-year-old woman with an unruptured SCA aneurysm who underwent endovascular surgery to occlude the parent artery. Neither patients exhibited any additional neurological deficits. SCA aneurysms often have either relatively wide or undefinable necks, so it is difficult to preserve the parent artery. According to several surgical reports, occlusion of the SCA appears well tolerated for a variety of reasons.