巨大脳底動脈瘤の1手術治験例—脳保護剤（仙台カクテル）とバルーンカテーテルを用いて

A Successfully Treated Case of Giant Basilar Artery Aneurysm utilizing a Balloon Catheter Occlusion and the Brain Protective Substances

I．はじめに

　脳動脈瘤の中でも最大径が25mm以上の巨大動脈瘤の手術は総じて困難であり，特に脳底動脈系の巨大動脈瘤は最も直達手術が困難であるとされている．最近われわれは最大径35mmにも及ぶ巨大脳底動脈瘤に対し，脳保護剤（仙台カクテル）の投与下にバルーンカテーテルテクニックを応用して動脈瘤への一時血流遮断を行いつつ直達摘出手術を施行し，根治せしめた症例を経験したので報告する．

A case of giant basilar artery aneurysm success-fully treated utilizing balloon catheter under the ad-ministration of 20% mannitol, dexamethasone, vitamin E (Sendai Cocktail) is reported.

The patient, 59 years old female, was admitted to our clinic with complaints of headache. CT scan revealed partially enhanced, round-shaped high den-sity mass with a diameter of 35 mm in the left posterior part of the basal cistern. Vertebral angio-graphy revealed aneurysm at the junction of left posterior cerebral artery and superior cerebellar artery. These findings indicate the partially thrombosed giant basilar artery aneurysm.