脳膿瘍に細菌性脳動脈瘤を合併した1手術例

A Case Presenting Brain Abscess with Multiple Infectious Aneurysms

Ⅰ．はじめに

　細菌性脳動脈瘤は，感染性心内膜炎に続発する感染性塞栓によることが多いとされているが，頭蓋内外の感染，炎症の直接的な波及もその原因の1つであると言われている．われわれは，発熱で発症し，その後段階的な巣症状の悪化を呈した，脳膿瘍と細菌性動脈瘤を合併した症例を経験したので，文献的考察とともに報告する．

We report a case presenting a brain abscess with multiple infectious aneurysms. A 59-year-old man was trans-ferred to our hospital suffering from left hemiparesis. MRI demonstrated a huge mass in the right frontal lobe with marked brain edema in the surrounding area. Diffusion-weighted image revealed heterogenous intensity, which is not typical in cases of brain abscess. Surgical removal was planned, and preoperative angiography was performed. An-giography demonstrated aneurysms at the distal branch of both the right middle cerebral artery and the anterior cere-bral artery.