Moyamoya血管に破裂動脈瘤を合併したMoyamoya類似病の1例

A Case of Atypical Moyamoya Disease with a Ruptured Aneurysm on Moyamoya Vessel

I．はじめに

　モヤモヤ血管自体に動脈瘤を認め，この破裂を確認した例は比較的稀のようである^{12,14,16,18）}．われわれは，最近モヤモヤ血管自体に発生したと思われる嚢状動脈瘤が破裂し，さらにその血腫が脳室内に穿破した症例を経験した．この症例の臨床経過について報告するとともに，これまで動脈瘤の合併したモヤモヤ病として報告されている例につき若干の文献的考察を加えたのであわせ報告する．

A 45-year-old female had sudden onset of severe headache,nausea and vomiting without any inducing moments andwas transfered to our hospital by an ambulance car. Onadmission the patient was alert and showed only signs ofmeningeal irritation. There were no other neurologicaldeficits at all.

Immediate CT examination revealed a small high densityspot in the area of the right basal ganglia, and a large highdensity in the frontal horns of both lateral ventricles.

Right carotid angiogram showed completely patentcarotid siphon with Moyamoya vessels.