一側頸動脈結紮術を施行した巨大脳動脈瘤のCT scanによる追跡

Follow-up Study of the Giant Aneurysm by CT Scan after Unilateral Carotid Ligation

I．はじめに

　microsurgeryの導入により，脳動脈瘤の手術成績は著しく向上したが，直径25mm以上の巨大脳動脈瘤に関しては，動脈瘤とparent arteryとの正確な位置関係の把握が困難なために，直達手術を断念せざるを得ない場合も多い．われわれは，比較的稀とされている直径25mm近くの巨大前交通動脈動脈瘤に対して，総頸動脈結紮術を施行し，この巨大脳動脈瘤のhemodynamic stressに対する変化をCT scanで追跡し，その病理解剖所見と対比する機会を得たので，症例を報告し，巨大前交通動脈動脈瘤に対する総頸動脈結紮術の効果について考察を行った．

We report a rare case of giant aneurysm of the anterior communicating artery, which was followed up by CT scan after unilateral carotid ligation.

A 50-year-old female visited our clinic complaining of headache and visual disturbance. Neurological examination revealed bitemporal hemianopsia and loss of visual acuity. A giant anterior communicating artery aneurysm was found on right carotid angiograms. After ligation of the right common carotid artery, the aneurysm was reduced in size. Three weeks later, however, it ruptured and the patient died two months later. Autopsy showed the ruptured dome of the aneurysm.