両側総頸動脈閉塞症に合併した破裂脳動脈瘤の1例

A Case of Aneurysmal Subarachnoid Hemorrhage Associated with Bilateral Common Carotid Artery Occlusion

Ⅰ．はじめに

　閉塞性脳血管病変に脳動脈瘤を合併した報告は散見されるが，比較的頻度の低い両側総頸動脈閉塞に破裂脳動脈瘤を合併することは非常に稀である^10,13,16）．今回，われわれは動脈硬化性病変により両側総頸動脈が閉塞し血行力学的負荷が成因と考えられた破裂性脳動脈瘤の1例を経験したので文献的考察を加えて報告する．

Cerebral aneurysm may occur in some cases of major cerebral artery occlusion. However, according to our search of the literature, only four cases of aneurysmal subarchnoid hemorrhage (SAH) associated with bilateral common ca-rotid artery occlusion (CCAO) have been reported in addition to the case we report here with a summary of the pre-viously reported cases. A healthy 82-year-old female was found unconscious and admitted to our hospital where her neurological state was diagnosed as Hunt & Kosnik grade Ⅱ, World Federation of Neurosurgical Societies grade Ⅱ.