両側性内頸動脈海綿洞部嚢状動脈瘤

BIRATERAL SACCULAR ANEURYSMS OF THE INTERNAL CAROTID ARTERY IN THE CAVERNOUS SINUS

Ｉ．はじめに

　海綿静脈洞部の特発性内頸動脈瘤は従来から女性に多いことが指摘^8）16）22）されており，該部の組織学的構造の特異性の問題^4）とともにはなはだ興味ある動脈瘤群である。

　一方，海綿静脈洞部の特発性両側性動脈瘤の報告はきわめて少なく，Wilson　＆　Myers （1963）^28）は自験1例を加え，いままでに計12例の報告しかないと述べている。

1) In a 57-year-old female, the formation of the unilateral carotid-cavernous fistula was observed during the course of bilateral internal carotid aneurysms in the region of cavernous portion. This carotid cavernous fistula was treated using muscle embolization after Hamby's technique. Three years have passed since the onset of the disease, 1 year and 4 months after the angiographi-cal detection and 16 months after the operation,but the patient is now in good condition.

2) The 18 cases of the bilateral intracavernous aneurysms of the internal carotid which have been published to date, including the present case, were reviewed and compared with the unilateral ones. The bilateral were rarer than the unilateral, but the clinical manifestations were the same as follows :

i) The disease was mainly seen in the middle aged female eventhough the reason was still obscure.

ii) The symptoms and signs were consisted mainly of headaches, eyeaches and cavernous sinus syndrom, but the clinical manifestations usually showed unilateral signs and hardly showed any bilateral signs.

iii) The treatment was not always quite as good as results including the unilateral lesion.