多発脳血管奇形の1例—中大脳動脈窓形成，Primitive trigeminal arteryの遺残に合併した多発脳動脈瘤の1症例

Multiple Anomalies of Cerebral Vessels:A case of multiple aneurysms associated with fenestration of the middle cerebral artery and persistent primitive trigeminal artery

I．はじめに

　脳動脈瘤と孫種頭蓋内血管奇形の合併に関する報告は多い^{2,4,18,20,24）}．　最近われわれは，4個の多発脳動脈瘤に中大脳動脈窓形成とprimhive trigeminal arteryの遺残を合併した症例を経験した．このような多彩な頭蓋内血管奇形を合併した症例の報告はなく，脳動脈瘤発生に及ぼす先天性因子を強く示唆する貴重な症例と考えられるので，文献的考察を加えて報告する．

A case of multiple intracranial anomalies was report-ed. They consisted of fenestration of the middlecerebral artery (MCA), persistent primitive trigeminalartery and four intracranial aneurysms.

The patient, 45-year-old male, had an attack ofsubarachnoid hemorrhage on July 15, 1982. He wastransferred and admitted to our Dept. of Neurosur-gery on July 27. On admission neurological examina-tions revealed retinal hemorrhage, bilateral papilledemaand abducens nerve paresis on the left.