脳保護物質投与下に動脈瘤柄部切除，内頸動脈端々吻合を行った頸部内頸動脈瘤の1例

Aneurysm of the Extracranial Internal Carotid Artery Treated by Neck Resection and End-to-End Anastomosis under the Administration of Brain Protective Substances

I．はじめに

　非外傷性の頸部内頸動脈瘤は比較的稀な疾患である^6,8,11）．本症の場合，動脈瘤柄部が内頸動脈近位側にある場合には根治手術の適応となるが，動脈瘤が大きい場合には手術操作に困難を伴うことが多い．

　われわれは，頸部内頸動脈近位側に柄部をもつ約4×5×5cmの動脈瘤に対し，脳保護剤（mannitol, dexamethasone，vitamin E）^20,21）併用投与により血管遮断時間の延長をはかり，動脈瘤柄部切除，内頸動脈端々吻合を行い根治し得た1症例を経験したので報告する．

A case of aneurysm of the extracranial internal caro-tid artery treated by aneurysmal neck resection and end-to-end anastomosis of the internal carotid artery under the administration of Sendai Cocktail, which is composed of 20% mannitol solution, dexamethasone and vitamin E and has brain protective effects fromischemia. The patient, a 55-year-old man, was admitted to Yonezawa City Hospital on October 11, 1984, with chief complaints of transient consciousness disturbance and left hemiparesis. On admission, no neurological de-ficit was found but pulsatile fixed mass was found in the right submandibular region.