Fibromuscular Dysplasia（FMD）に起因した前大脳動脈解離性動脈瘤の1例

Anterior Cerebral Artery Dissecting Aneurysm Associated with Fibromuscular Dysplasia (FMD) : A Case Report

I．はじめに

　Fibromuscular dysplasia（FMD）は非動脈硬化性，非炎症性の狭窄を主体とする血管病変（angio-pathy）であり，腎動脈や頭頸部動脈に多く発生する．中年女性に多いと言われるが，原因はいまだ不明である．今回われわれはFMDが前大脳動脈という稀な部位に見られ^8），しかも解離性動脈瘤の成因につながった興味ある1例を経験し，放射線学的だけでなく，病理組織学的にも検討する機会を得たためその詳細を報告する．

We have recently encountered a rare case of anterior cerebral artery dissecting aneurysm, presenting cerebral infarction and subarachnoid hemorrhage, associated with fibromuscular dysplasia (FMD). A 50- year-old woman was admitted to our hospital with complaints of headache and hemiparesis. A right caro- tid angiogram obtained 9 hours after the onset revealed stenosis and slight dilatation in the A1 portion of the anterior cerebral artery. At 12 hours after the onset, the patient fell into a coma. CT scan showed dif- fuse subarachnoid hemorrhage. An angiogram hadrevealed aneurysmal dilatation and double lumen intheA1 portion, but, 34 days after the onset, angiogramshowed growth of the aneurysm in the Al portion andstenosis in the A2 and A3 portions. At 38 days afterthe onset, the trapping of the dilated aneurysm topre-vent rerupture was performed. Pathological diagnosiswas concluded to be FMD. We concluded that FMDcaused stenosis as well as the formation and ruptureof the dissecting aneurysm in the anterior cerebralartery.