巨大前交通動脈瘤の直接手術治験例

A Case of Giant Aneurysm at the Anterior Communicating Artery treated by Direct Surgery

Ⅰ．はじめに

　巨大脳動脈瘤に対する直接手術はmicrosurgical techniqueの発達した今日においても，その手術成績はおもわしくなく，特に鞍内鞍上部巨大脳動脈瘤はuntouchableとさえいわれ，carotid ligationや保存的療法を余儀なくさせられる場合が多い^1,7,11）．

　今回，われわれは40×40×35mmにもおよぶ鞍内鞍上部巨大前交通動脈瘤に対し，その根治手術に成功したので，症例を呈示し手術法の要点について報告する．

The patient, a 54-year-old male, was suddenly attacked with severe headache and unconsciousness in March 1968.

Since then he complained headache and became aware of decreased visual acuity in his right eye. He visited an ophthalmological clinic and was referred to our department of neurosurgery under the suspicion of parasellar tumor. Cerebral angiogram revealed a giant aneurysm of the anterior communicating artery. CT scan revealed a ring shape high density area about 35 mm in diameter and the center of its high density area enhanced by conray infusion.