直達手術困難な頭蓋内巨大内頸動脈瘤症例の長期予後

Follow-up Study of Inaccessible Giant Aneurysms of the Intracranial Internal Carotid Artery

I．はじめに

　直達手術が困難な頭蓋内巨大内頸動脈瘤に対しては，従来から頸部での総頸ないしは内頸動脈の結紮術^6），内頸動脈結紮術にEC-IC bypassの併用^2），copper wireによるelectrothrombosis^5,8），さらに最近のintravascular　surgeryの応用^7,9）など多くの方法が試みられている．しかし，いずれの方法にも限界があり，保存的に経過を見ざるを得ない症例も多い．したがって，このような症例の長期予後を知ることは治療方針の決定上極めて重要と考えられる．

　今回著者らは頭蓋内巨大内頸動脈瘤症例のうち，長期にわたりCT所見と神経症状の推移を追跡しえた8症例の長期予後を検討し，若干の知見を得たので報告する．

Inaccessible giant aneurysms of the internal carotid artery had been treated with various methods. But these results are not always satisfactory. To deter-mine the optimal treatment for these aneurysms, long-term follow-up study was carried out in 8 patients. They included 7 female and one male with age ranged from 18 to 72 years. The aneurysms arose at the cavernous portion in 6 patients, at bifurcation of the posterior communicating artery and the ophthalmic artery in 2 patients. All but 2 patients had multiple cranial nerve palsies before admission.