椎骨動脈・脊髄動脈分枝分岐部動脈瘤の1症例

A Case of Aneurysm at The Junction of The Vertebral Artery and A Spinal Artertal Branch

I．はじめに

　椎骨脳底動脈領域の動脈瘤の発生頻度は脳動脈瘤の5％前後と少ないものであるが^{9, 14）}，このうち椎骨動脈瘤は，椎骨動脈後下小脳動脈分岐部に発生するものが大部分であり^{10, 11, 19）}，後下小脳動脈分岐部以外の椎骨動脈瘤の発生は稀である．

　われわれは，後下小脳動脈分岐部より近位側に発生した椎骨動脈と脊髄枝との分岐部の動脈瘤を経験し治癒せしめたので，臨床経過，検査所見を報告するとともに若干の考察を述べる．

A 68-year-old male suffered from severe oc-cipitalgia, nausea, and vomiting was admitted to our hospital. On admission, he complained only of headache and displayed no evidence of disturbed consciousness or neurological deficits. A computed tomographic (CT) scan revealed a subarachnoid hemorrhage in the basal subarachnoid cisterns, with the thickest, densest area in the bilateral ambient cisterns. Four-vessel angiograms disclosed no patho-logical findings. The patient was treated with bed rest and his blood pressure was maintained below 120 mmHg.