雑誌文献を検索します。書籍を検索する際には「書籍検索」を選択してください。

Neurological Surgery No Shinkei Geka Volume 18, Issue 11 （November 1990）

Neurological Surgery 脳神経外科 18巻11号（1990年11月発行）

Japanese English

症例

Carotid-Anterior Cerebral Artery Anastomosisの3例の経験 Three Cases of Carotid Anterior Cerebral Anastomosis 伴貞彦 ¹ , 中津正二 ¹ , 松本茂男 ¹ , 佐藤慎一 ¹ , 本崎孝彦 ¹ , 山本豊城 ¹ Sadahiko BAN ¹ , Shoji NAKATSU ¹ , Shigeo MATSUMOTO ¹ , Shinichi SATO ¹ , Takahiko MOTOZAKI ¹ , Toyoshiro YAMAMOTO ¹ ¹神戸市立中央市民病院脳神経外科 ¹Department of Neurosurgery, Kobe City General Hospital キーワード： Vascular anomaly , Anterior cerebral artery , Internal carotid artery , Aneurysm , Subarachnoid hemorrhage Keyword: Vascular anomaly , Anterior cerebral artery , Internal carotid artery , Aneurysm , Subarachnoid hemorrhage pp.1071-1077

発行日 1990年11月10日 Published Date 1990/11/10

DOI https://doi.org/10.11477/mf.1436900171

PDF(8898KB)

有料閲覧

Abstract 文献概要
1ページ目 Look Inside

I．はじめに

　Carotid-anterior cerebral artery anastomosisは1959年Robmson^11）が剖検例の報告を最初にして以来，過去21例の報告を見るのみである．また名称も，^1）infraoptic course of the anterior cerebral artery（ACA），^2）anomalous branch of ICA，^3）anomalousorigin of ACA，^4）inter-optic course of ACAなどと呼ばれており^1-9,11-17），その起源についても定説はない．著者らは，同血管奇形に脳動脈瘤を合併し，クモ膜下出血（SAH）で発症した2例と脳内出血で発病症した1例について，文献的考察を加え報告する．

Three cases are presented with rare carotid-anterior cerebral anastamosis (anomalous ACA) originating from the internal carotid artery at the level of the ori-gin of the ophthalmic artery, running first underneath and then between both optic nerves, and finally joining the anterior communicating artery.

Case 1 (47 year-old woman) and case 2 (56 year-old man) were both admitted with subarachnoid hemor-rhage from a ruptured aneurysm, which was located at the anomalous ACA (carotid-ACA anastomosis) . Case 3 (61 year-old man) was diagnosed as having left occi-pital intracerbral hematoma on CT, and bilateral ano-malous ACA was found on angiograms. This anoma-lous ACA is very rare; only 21 cases have been re-ported in the literature.

Several synonyms have been proposed as follows: 1) infraoptic course of the anterior cerebral artery (ACA) , 2) interoptic course of ACA, 3) an anomalous branch of the internal carotid artery (ICA) and 4) an anastomosis between the ICA and the ACA (carotid-ACA anastomosis).

In cases with this carotid-ACA anastomosis, co-existing intracranial aneurysm has been reported. However, this is the first report of ruptured aneurysm located at the anomolous ACA itself.

Case 1 and 2 were operated on through the ipsilater-al pterional approach and the aneurysm was successful-ly clipped. Postoperative course was uneventful in each case. Case 3 was treated conservatively.

From the angiographical and operative findings, we prefer to use “carotid-anterior cerebral artery anastomo-sis” as the medical terminology best suited to describe this condition.