静脈片移植により血行再建を行った頭蓋内巨大内頸動脈瘤根治手術の1例

A Case of Extra-intracranial Bypass Venous Graft for Giant Internal Carotid Aneurysm

Ⅰ．はじめに

　直達手術の困難な内頸動脈サイフォン部巨大紛錘形動脈瘤を内頸動脈循環から遊離，同時に動脈瘤体部を切開吸引後縫縮し，更に25cmにおよぶ遊離自家静脈片により頭蓋内血行を再建して根治せしめ得た症例を最近経験したので，本手術法の要点ならびに術後経過と術前後の諸検査結果に基づく検討を併せて報告する．

A male patient, aged 42, (No. 780624) was admitted to the Department of Neurosurgery of Hirosaki University Hospital, complaining recent weight loss, intolerance to cold and visual disturbance of the right eye.

Ophthalmological examination revealed the optic atrophy with decreased visual acuity and concentric visual defect of the right eye. Endocrinological examination showed almost general supression of adenohypophyseal function except abnormal high level resetting of cortisol diurnal rhythm.