破裂中大脳動脈瘤と前頭蓋窩硬膜動静脈瘻の合併した1例

A Case of Ruptured Aneurysm of the Middle Cerebral Artery Associated with Dural Arteriovenous Fistula in the Anterior Cranial Fossa

Ⅰ．はじめに

　脳動脈瘤と脳動静脈奇形の合併する頻度は5〜10％といわれている^17）．また脳動脈瘤と硬膜動静脈瘻の合併した報告例は，過去に10例あり^{3,6,8,9，12,15,17）}，そのうち5例が前頭蓋窩硬膜動静脈瘻との合併例である^6,9,15,17）今回われわれは，破裂中大脳動脈瘤に偶然合併したと考えられる前頭蓋窩硬膜動静脈瘻の症例を経験し，2期的に手術を行ったので，文献的考察を加えて報告する．

A 66-year-old man suffered from subarachnoid hemorrhage due to the rupture of a right middle cerebral artery an-eurysm that was detected by 3D-CTA. He underwent an emergent clipping operation. Incidentally, postoperative DSA demonstrated chiral arteriovenous fistula in the left anterior cranial fossa, which was fed by the left anterior eth-moidal artery and drained into the superior sagittal sinus via the cortical vein of the left frontal lobe. We performed electrocoagulation and division of the fistula at the second surgery.