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Moyamoya Disease with Intraventricular Hemorrhage due to Rupture of Lateral Posterior Choroidal Artery Aneurysm : case report Masayoshi MAEKAWA 1 , Shigeru NEMOTO 1 , Sakae AWAYA 2 , Akira TERAMOTO 3 1Department of Neurosurgery, Mejiro Hospital 2Department of Neurosurgery, Tokyo Metropolitan Police Hospital 3Department of Neurosurgery, Nippon Medical School Keyword: moyamoya disease , intraventricular hemorrhage , collateral vessel , endovascular embolization pp.1047-1051
Published Date 1999/11/10
DOI https://doi.org/10.11477/mf.1436901812
  • Abstract
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Intracranial aneurysms associated with moyamoya disease are often reviewed. Aneurysms not aroundthe circle of Willis but on the collateral vessels are rare.

A 71-year-old woman presented with sudden onset of severe headache and vomiting. CT scan showedan intraventricular hemorrhage from bilateral lateral ventricle to fourth ventricle. Cerebral angiographyshowed the occlusion of the terminal portion of the bilateral internal carotid artery with moyamoya vesselsand three aneurysms at the distal portion of the left lateral posterior choroidal artery. Clinical symptomsimproved day by day, but 17 days later, due to rebleeding of the aneurysms the patient fell into coma. Theday after rebleeding, endovascular embolization was performed using liquid particle, and the left lateralposterior choroidal artery and the aneurysm were occluded. Brain infarction with massive brain edema ofthe left cerebral hemisphere resulted in the patient's death.

The management of the aneurysms in the basal ganglia and on the collateral vessels associated withmoyamoya disease is controversial. We suggest positive intervention during the acute stage for theperipheral artery aneurysms taking endovascular embolization into consideration to prevent rupture or re-bleeding.


Copyright © 1999, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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