急性硬膜下血腫で発症した細菌性脳動脈瘤と思われる末梢性脳動脈瘤の1例

A Ruptured Distal Aneurysm, Thought to Be a Mycotic Aneurysm, Associated with Acute Subdural Hematoma:Case Report and Review of the Literature

Ⅰ．はじめに

　脳動脈瘤破裂による急性硬膜下血腫の報告は散見されるが，末梢性脳動脈瘤による急性硬膜下血腫の報告は少ない^11）．中でも細菌性脳動脈瘤によるものは極めて稀である．

　われわれは，細菌性と思われる末梢性中大脳動脈瘤からの出血による急性硬膜下血腫の1例を経験したので報告する．

A case is described of a ruptured intracranial mycotic aneurysm in the distal middle cerebral artery associated with an acute subdural hematoma. A 55-year-old woman, with a history of tuberculous meningitis at the age of 7, pre-sented left hemiparesis. She was in a state of semi-coma. Computed tomography scan showed a right acute subdural hematoma. Magnetic resonance angiography revealed no cerebral aneurysm. Emergency external decompression was performed and a distal central artery aneurysm was found and was resected during the operation.