もやもや病に合併した脳底上小脳動脈瘤，後大脳動脈瘤の1手術例

Surgical Treatment of Aneurysms at Basilar Artery and Posterior Cerebral Artery Associated with Moyamoya Disease:A case report

I．はじめに

　モヤモヤ病は椎骨脳底動脈系の動脈瘤をしばしば合併するが，その手術例の報告は比較的稀である．われわれは脳底動脈系に2個の嚢状動脈瘤を合併したモヤモヤ病に対し手術を施行した症例を経験したので文献的考察を加え報告する．

This report describes a surgical case of basilar-superior cerebellar (BA-SCA) junction aneurysm and posterior cerebral artery (PCA) aneurysm associated with moyamoya disease.

A-38-year-old man in an unconsciousness state and with mild left hemiparesis was referred to our hospital. CT scan demonstrated hemorrhage in the right basal ganglia. Carotid angiograms showed stenoses at the ter-minal portion of the bilateral internal carotid arteries and moyamoya vessels. Left vertebral angiograms showed two aneurysms at the junction of the right su-perior cerebellar artery and the basilar artery and at the P1 portion of the left posterior cerebral artery. Two aneurysms were successfully clipped using the pterional approach. Bilateral encephaloduroarteriosynangiosis (EDAS) was also performed for the treatment of Moyamoya disease.

Postoperative angiograms revealed complete clipping of the aneurysms and the postoperative course was un-eventful.