くも膜下出血で発症し，脳血管撮影にて完全閉塞の所見を呈したM2部解離性中大脳動脈瘤の1例

Dissecting Aneurysm of the Middle Cerebral Artery with Subarachnoid Hemorrhage Showing Complete Occlusion at the M2 Portion of the Middle Cerebral Artery on Preoperative Angiograms:Case Report

Ⅰ．はじめに

　近年，解離性中大脳動脈瘤の報告が増加しているが，診断と治療に難渋している症例が多い．われわれも，くも膜下出血と脳出血を併発したM2部解離性中大脳動脈瘤の1例を経験したが，術前の脳血管撮影にてM2末梢部の完全閉塞の所見を呈していたために，明らかな術前診断ができずに緊急手術に臨んだ症例であった．診断と治療に関し，文献的考察を加え報告する．

We present a surgical case of a dissecting aneurysm of the middle cerebral artery associated with subarachnoid hemorrhage and intracranial hemorrhage. A 29-year-old man suddenly fell into a comatose state, and was referred to our hospital. CT scan showed diffuse subarachnoid hemorrhage and an intracerebral hematoma with marked midline shift located in the right frontal lobe. The right carotid angiogram revealed complete occlusion at the M2 portion of the middle cerebral artery, but failed to reveal any aneurysms in the rest of the intracranial circulation.