脳動脈瘤の家族発生例

FAMILIAL CASES OF CEREBRAL ANEURYSM

緒言

　脳動脈瘤は臨床神経学においても，また最近は脳神経外科学においても，極めて重要な疾患の一つとなつており，多くの臨床経験や研究がなされている。それにもかかわらず，脳動脈瘤の成因，あるいは発生機序について，未だ確定的なものはない。特に脳動脈瘤がくも膜下出血，あるいは頭部外傷で，偶然的に発見される機会が多いために，それが先天的に存在していたものか，あるいは後天的に何らかの原因で発現したものであるかは，しばしば問題となる点である。

　本症が先天的な奇形，あるいは胎生期の形成異常によつて発生すると説明する立場があるが，その考え方の重要な根拠となつているのは，本症が家族性に発生するという臨床的な事実があるからである。

This is a report of the cerebral aneurysm with attack of subarachnoid hemorrhage on a brother and a sister, and also a brief review on the literature dealing with familial cases of cerebral aneuaysm.

Case 1. A 52-year-old male.

The patient was admitted to the hospital with subarachnoid hemorrhage, and he was confirmed to have sacular aneurysm of the right posterior com-municating artery by the carotid angiography and craniotomy. He passed away on the second post-operative day.

Case 2. A fifty-year-old female (the sister of Case 1.)

She was also admitted to our clinc with subara-chnoid hemorrhage and was diagnosed to have a saccular aneurysm of left posterior communicating artery by the carotid angiography and symptoms.

In the examinations of the 29 familiar cases re-ported in literatures and our two cases with re-ference to the age of onset, the site of occurrence and clinical symptoms, we find not any specific defference in common cerebral aneurysm excepting that there is no case report of aneurysm of the basilar artery and that aneurysm at the posterior communicating artery is more frequent and is often of a multiple nature.

Some discussion was made on our two familial cases as well on the 29 cases reported.