脳膿瘍摘出術後に発生し自然治癒した脳末梢動脈瘤—1症例と文献的考察

Peripheral Arterial Aneurysm of the Brain Occurring after Brain Abscess Extirpation and Healing Spontaneously:Report of a Case and Review of the Literature

Ⅰ．はじめに

　最近我々は，脳膿瘍摘出術後，手術野に一致した中大脳動脈末梢の一分枝に，術後発生したと思われる粟粒大の嚢状動脈瘤を脳血管写上認めた1例を経験した．脳血管写で経過を追ったところ，動脈瘤は一時増大傾向を示したが，その後漸次縮小し，ついには消失した．脳膿瘍摘出術後という特異な背景をもつ本症例の病因論とあわせて，脳末梢動脈の外傷性動脈瘤について文献的考察を試みた．

In 33 year-old man an aneurysm of a pheripheral branch of the right middle cerebral artery was disclosed by angiography 8 days after extirpation of a parietotemporal brain abscess. The aneurysm was absent in the preoperative angiogram. Since the site of the aneurysm coincided with the operative field, it is sure that the etiology of the aneurysm was related to operative trauma and/or arteritis. Although inflammatory or mycotic factor could not be excluded from its etiology, it seems reasonable that traumatic factor was major one. The aneurysm was found to have disappeared eventually in the angiogram made on 372th postoperative day.