Villaret症候群を呈した外傷性頭蓋外巨大内頸動脈瘤の1症例

Villaret's Syndrome Due to Extra-cranial Internal Carotid Aneurysm: A case report

I．はじめに

　いわゆる下位脳神経叢は頭蓋腔を出てから頸部に至るまでは近接して下行する，したがってその領域に病変を生じた場合，末梢性の複合神経障害が出現するが，その神経の組み合わせにより，いくつかの症候群が記載されている^7）．

　今回われわれは，右後頸部の穿通性外傷後に頸部内頸動脈に巨大な動脈瘤を生じ，かつVillaret症候群すなわち右側IX-XII脳神経麻痺およびHorner症候群を合併した症例を経験したので，若干の文献的考察を加え報告する．

A 69 year-old male was admitted to our clinic withthe chief complaint of hoarsness and difficulty inswallowing. These symptoms occurred about 5months after penetrating neck injury. Neurologicalexamination revealed right nineth to twelfth cranialnerves palsy and Horner's syndrome. Plain skull X-Pdemonstrated two broken pieces of glass below theright mastoid processus. The right carotid angiogramshowed a 45×25mm aneurysm originated fromthe right internal carotid artery just below the carotidcanal.

As the first operation, gradual occlusion of rightinternal carotid artery combined with the right STA-MCA anastmosis was performed.