3D-CTAが有用であった重複中大脳動脈分岐部破裂動脈瘤の1例

The Usefulness of 3D-CTA for the Diagnosis of a Ruptured Aneurysm at the Origin of the Duplicated Middle Cerebral Artery:Case Report

Ⅰ．はじめに

　中大脳動脈の血管奇形として重複中大脳動脈の報告例は散見されるが^4），さらに同血管の分岐部に動脈瘤を合併している例は稀である．今回われわれはくも膜下出血で発症し，脳血管撮影にて右内頸動脈に重複中大脳動脈を認めたが，破裂動脈瘤の確認が困難であり，3D-CTAにて同血管分岐部に動脈瘤を確認し得た症例を経験した．過去に報告された重複中大脳動脈分岐部動脈瘤はわれわれが渉猟し得た限りでは14例^1-3,6-14）あり，今回の症例を含めて検討を加えたところ，若干の新たなる知見が得られたので報告する．

Duplication of the middle cerebral artery is known as a rare anomalous vessel arising from the internal carotid artery and an aneurysm at the origin of the duplicated middle cerebral artery is very rare. We presented a case of ruptured aneurysm at the origin of the duplicated middle cerebral artery and discussed the usefulness of 3D-CTA (threedimensional computed tomographic angiography) for its diagnosis. A 34-year-old female suffered from severe headache and was admitted to our hospital.