手術中の動脈損傷による外傷性脳動脈瘤の1例

A Case of Iatrogenic Traumatic Intracranial Aneurysm

I．はじめに

　頭部外傷による外傷性脳動脈瘤の発生についてはよく知られているが，手術中の動脈損傷による外傷性脳動脈瘤（以下TA）の報告例は比較的少数である．われわれは，脳腫瘍摘出術中の動脈損傷に起因したTAを摘出し，その病理組織学的検索を行った結果，積極的に根治手術を行うべきと考えられたので，文献的考察を加え報告する．

A case of traumatic aneurysm due to an arterial in-jury during removal of a tuberculum sellae meningioma is reported. A 43-year-old man had undergone cra-niotomy for removal of the tumor. It was very hard with many feeders from bilateral anterior cerebralarteries (ACA), so the resection between the left ACA and the tumor was difficult. A small artery was accidentally pulled out from the left ACA and bleeding occurred from the small artery in the artery. The ACA was trapped temporarily with two clips and was coated using Oxycell and Biobond. The bleeding was stopped by this procedure and the blood reflowed.