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Ⅰ.はじめに
鏡面像を呈する脳動脈瘤にはしばしば遭遇するが,その多くは中大脳動脈であり,前大脳動脈遠位部(distal anterior cerebral artery:DACA)での発生は極めて稀である6).近年の未破裂脳動脈瘤の観察研究によると,サイズが5mm以下の脳動脈瘤の破裂率は一般的には低いとされるが8,10),実際の臨床では5mm未満,さらには3mm以下の極小瘤の破裂症例もときに経験する.
今回われわれは,鏡面像を呈したDACAの極小破裂脳動脈瘤の1症例を経験したので,文献的考察を加えて報告する.
Distal anterior cerebral artery(DACA)aneurysms have a low incidence. Particularly, DACA mirror aneurysms are extremely rare, although DACA multiple aneurysms are not rare. Generally, it is said that tiny aneurysms have a low risk of rupture. However, we sometimes encounter cases of ruptured tiny aneurysm. We describe a rare case of a mirror image of DACA ruptured tiny aneurysm.
A tiny aneurysm can rupture if the aneurysmal wall is fragile. Detection of the aneurysm may often be difficult with a single modality, even if the modality is digital subtraction angiography. Moreover, the distribution of subarachnoid hemorrhage may not be typical.
It might be important to capture a slight change of aneurysm in follow-up imaging to detect a ruptured aneurysm over multiple iterations of imaging.
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