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 28, Issue 4 （April 2000）

Neurological Surgery 脳神経外科 28巻4号（2000年4月発行）

Japanese English

研究

Posterior Circulation末梢部脳動脈瘤の治療経験 Treatment of Peripheral Aneurysms of the Posterior Circulation 石川栄一 ^1,3,4 , 谷中清之 ³ , 目黒琴生 ¹ , 成島浄 ¹ , 鈴木謙介 ¹ , 和田光功 ² , 能勢忠男 ³ Eiichi ISHIKAWA ^1,3,4 , Kiyoyuki YANAKA ³ , Kotoo MEGURO ¹ , Kiyoshi NARUSHIMA ¹ , Kensuke SUZUKI ¹ , Mitsuyoshi WADA ² , Tadao NOSE ³ ¹筑波メディカルセンター病院脳神経外科 ²筑波メディカルセンター病院放射線科 ³筑波大学臨床医学系脳神経外科 ⁴筑波記念病院脳神経外科 ¹Departments of Neurosurgery, Tsukuba Medical Center Hospital ²Departments of Radiology, Tsukuba Medical Center Hospital ³Department of Neurosurgery, Institute of Clinical Medicine, University of Tsukuba ⁴Department of Neurosurgery, Tsukuba Memorial Hospital キーワード： posterior circulation , peripheral aneurysm , endovascular treatment , proximal occlusion Keyword: posterior circulation , peripheral aneurysm , endovascular treatment , proximal occlusion pp.337-343

発行日 2000年4月10日 Published Date 2000/4/10

DOI https://doi.org/10.11477/mf.1436901872

PDF(8928KB)

有料閲覧

Abstract 文献概要
1ページ目 Look Inside

I．はじめに

　Posterior circulation（後大脳動脈及び椎骨脳底動脈系）の末梢部に発生する脳動脈瘤は非常に稀であり，その治療に苦慮することが多い．われわれは最近7例のposterior circulationの末梢性脳動脈瘤を経験した．これらの経験をもとに，pos-terior circulationの末梢性脳動脈瘤に対する治療戦略について論ずる．

Peripherally located aneurysms of the posterior circulation are extremely rare. The outcome of patients with peripherally located aneurysms has been poor, and the treatment of such aneurysms has been surgi-cally challenging. We report a consecutive series of peripherally located ruptured aneurysms in the pos-terior circulation, and discuss in this article the optimal treatment strategy for such lesions. Clinical pre-sentation, neuroradiological findings, treatment method, and the outcome were reviewed retrospectively.Two cases with distal posterior cerebral artery aneurysm, two with distal posterior inferior cerebellar artery aneurysni, two with anterior inferior cerebellar aneurysm, and one with superior cerebellar artery aneurysm were included in this study (mean age, 59.3±16.0, M:F=1:6). Three patients with good neu-rological status on admission who underwent clipping of the aneurysmal neck via craniotomy showed a favorable outcome. In contrast, four patients with poor neurological status on admission who underwent endovascular proximal occlusion of the parent artery showed an unfavorable outcome. Although the out-come of patients who underwent endovascular surgery was poor, endovascular proximal occlusion was effective in preventing re-rupture of the aneurysms. Proximal occlusion of the parent artery has several shortcomings such as cerebral infarction, but proximal occlusion at the very distal area of the parent arte-ries would not be critical because of good collateral circulation. Thus, endovascular proximal occlusion may provide us another option in the treatment of peripherally located aneurysms especially in patients with poor neurological status. Further data is needed to discover the optimal treatment for patients with peripherally located cerebral aneurysms.