慢性硬膜下血腫を合併した前交通動脈瘤の1例

An Anterior Communicating Artery Aneurysm Complicated by Chronic Subdural Hematoma:A case report

I．はじめに

　脳動脈瘤破裂に起因する硬膜下血腫の発生頻度は剖検例においてはほぼ1.9-17％^{5,15,17,19）}，臨床例では0.5-7.9％^{1,7,11,13,18）}といわれている．そのなかでいわゆる慢性硬膜下血腫型の血腫を伴う例は少なく，理在まで9例の報告をみるのみである^{1,2,4,8,11,14,16）}．今回われわれは慢性硬膜下血腫を合併した破裂前交通動脈瘤症例を経験したが，これまでの9例の報告には前交通動脈瘤症例はなく，興味ある症例と考え，若干の文献的考察を加えて報告する．

A 53-year-old housewife was admitted to the Department of Neurosurgery, Toyama Medical and Pharmaceutical University on June 6, 1980, because of disorientation, urinary incontinence and left hemiparesis. She had experienced "a fit of severe headache" many times for five years. On May 12, 1980, she experienced an abrupt, severe headache in a lavatory and was immediately brought to a nearby hospital. Her symptom was recovered gradually for a week but she experienced sudden onset of severe headache again on May 20. Subsequently, her state of consciousness gradually worsened and left sided hemiparesis arose.