椎骨脳底動脈系血管障害に合併した未破裂脳動脈瘤の5例

Unruptured Intracranial Aneurysms Associated with Vascular Disorder of the Vertebro-basilar System: Report of five cases

I．はじめに

　近年，stroke patientに未破裂脳動脈瘤が発見される機会が多くなり，多少の異論はあるものの積極的に手術される傾向にある．しかし，基礎となる脳血管障害の病型や程度により，術後成績が必ずしも良くない場合のあることが最近指摘されるようになってきている^6,8,13）．特に基礎疾患が椎骨脳底動脈系にある場合は，手術適応を含む患者管理には格別の配慮が必要となると考えられる．

　われわれは最近このような症例を5例経験し，そのうち4例に手術を行ったところ，3例に術後一時的な意識障害を中心とした神経症状の増悪をみた．本稿ではこれらの臨床経過を報告するとともに，このような症例における患者管理上の問題点を検討した．

Among fifty-two angiographically examined patients of vertebro-basilar disorder, incidental intracranial aneurysms were found in five cases. These were four males and a female, ages ranging from 42 - 67 year old. Vertebro-basilar disorders were ischemic origin in three cases and hemorrhage in two cases. Locations of in-cidental aneurysms were the internal carotid artery, middle cerebral artery, anterior communicating artery and basilar artery. They were multiple in three cases. They were operated on radically, except one case whose status seemed to be untolerable to the operation.