頭蓋内巨大脳底動脈瘤の1例

Giant Basilar Aneurysm:A Case Report

はじめに

　頭蓋内脳動脈瘤は，その破裂に起因するくも膜下出血で発症する場合がほとんどであるが，なかにはくも膜下出血を来さず，徐々に進行するmass signとして発症し，脳血管写で始めて巨大な動脈瘤が発見されることがある．

　頭蓋内巨大脳動脈瘤の定義は，諸家により多少の相違が見られるが，最大径25mm以上のものを巨大脳動脈瘤とする場合が多い．巨大脳動脈瘤は，発生部位，症状の発現様式では，一般にそれ以下の大きさの脳動脈瘤とは異なり，また直接手術が困難なことが多い．

A case of a giant aneurysm arising from the basilar artery is presented. The patient, a 41-year-old female, had recent memory disturbances, miscalculations and hemiparesis on admission. Vertebral angiograms displayed a giant aneurysm measuring approximately 66 mm in diameter arising from the basilar artery, a tortuous vertebral artery, an extremely dilated basilar artery and an agenesis of the left carotid artery.

Due to the enormous size of the aneurysm and its location in the deep intracranial portion, radical surgery was abandoned. Six months following her discharge, she died.