Staged bilateral VA occlusionを行ったくも膜下出血発症の両側椎骨動脈解離の1例

Staged Bilateral VA Embolization for SAH Due to Bilateral VA Dissection:Case Report

Ⅰ．はじめに

　椎骨動脈解離は若年成人では比較的多くみられ，特に後頭蓋窩の脳卒中の重要な原因の1つとして知られている^3）．一般に椎骨動脈解離は一側性であることが多く，両側の椎骨動脈解離の報告は比較的稀である．今回われわれはくも膜下出血で発症した両側椎骨動脈解離に対し，二期的に両側の椎骨動脈の近位部塞栓術を行い，良好な結果を得た症例を経験したので，若干の文献的考察を加えて報告する．

Vertebral artery (VA) dissections are uncommon, but are increasingly recognized as a cause of posterior circula-tion stroke in young adults. We describe a patient with bilateral VA dissection who presented SAH. The patient was successfully treated by proximal coil occlusion of the bilateral vertebral arteries in two stages. In the treatment of SAH due to bilateral VA dissection, it is important to estimate the status of the treated vessels or contralateral vesssels by follow-up angiography. Staged bilateral proximal VA occlusions should be considered in the case of recur-rent VA dissection or progressive aneurysm enlargement.