くも膜下出血および脳梗塞を呈した前大脳動脈解離性動脈瘤の1例

Spontaneous Dissection of the Anterior Cerebral Artery Presenting Subarachnoid Hemorrhage and Cerebral Infarction: A Case Report

I．はじめに

　前大脳動脈解離性動脈瘤は従来比較的稀な疾患と考えられてきた．近年，脳血管撮影の解像力が向上し，その報告例は増加傾向にある．また，computerized tomographic angiography（CTA）やmagnetic resonance angiography（MRA）が確定診断に有用であった例も報告されている^3）．今回われわれは，脳虚血症状およびくも膜下出血を来した前大脳動脈解離性動脈瘤の1例を経験したので，文献的考察を加えて報告する．

A case is reported of anterior cerebral artery dissecting aneurysm presenting with subarachnoid hemor-rhage and cerebral infarction. A 50-year-old man presented with sudden onset of weakness of the left low-er limb was admitted to our hospital. CT scan on admission showed a subarachnoid hemorrhage ln the in-terhemispheric fissure and CT on the 6th day demonstrated a cerebral infarction on the right medial fron-tal lobe. A carotid angiogram 12 hours after the onset showed no aneurysmal leslon, but, the angiogram re-peated 11 days after the onset revealed an aneurysmal dilatation with distal narrowing at the right A2-A3 segment.