くも膜下出血にて発症した小児脳動脈瘤破裂の2例

Ruptured Cerebral Aneurysm in Childhood : Report of Two Cases

I．はじめに

　脳動脈瘤は成人にくも膜下出血として発症することが多く，小児期に発症することは稀である^1-13）．われわれは2例の小児（年長児）の脳動脈瘤破裂によるくも膜下出血を経験したので，文献的考察を加えて報告する．

We report two pediatric patients with rupture of cerebral aneurysm developing subarachnoid hemor-rhage. These two patients complained of headache and vomiting. Patient 1 was a 15-year-old girl. Cranialcomputed tomography (CT) showed a high density area in the left sylvian fissure, suggesting subarach-noid hemorrhage. Left carotid arteriography revealed an aneurysm at the left internal carotid arterybifurcation. Surgical pathology showed a saccular type aneurysm with disappearance of internal elasticmembrane. Patient 2 was a 14-year-old girl. Cranial CT exhibited a high density area in the basal cisternand hematoma in the right frontal lobe, penetrating to the right lateral ventricle. Right carotid arteriogra-phy showed a right anterior cerebral aneurysm in the right anterior cerebral artery. Both patients under-went craniotomy and trapping successfully, and their subsequent clinical courses were uneventful.