Temporary clip部に発生したaspergillus脳動脈瘤の1例

A Rare Case of Cerebral Aspergillus Aneurysm at the Site of Temporary Clip Application

I．はじめに

　細菌性脳動脈瘤のうちで真菌によるものは稀であり報告例もまだ少ない．

　われわれは脳動脈瘤の手術後に，術中temporary clipをかけた部位に一致して新生脳動脈瘤が発生しその破裂により死亡した症例で，剖検により発生部位にasper—gillusの増殖を認めた稀な1例を経験した．この新生脳動脈瘤の発生機序を中心に若干の考察を加えて報告する．

Anterior communicating artery aneurysm was shown in a 48-year-old man who had suffered from subarach-noid hemorrhage (SAH) by cerebral angiography. Right pterional approach was performed on the 40th day after SAH. Premature rupture occurred during aneurysmal manipulation and temporary clip (Scoville clip) was placed at the middle of the right A1 segment for fifteen minutes. The anterior communicating artery aneurysm was successfully clipped and postoperative course was uneventful. But, four days after the opera-tion, the patient fell into coma following generalized tonic convulsion. Lumbar puncture showed fresh SAH.