末梢性上小脳動脈動脈瘤の1例

概要

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The patient, a 37-year-old female, was hospitalized with a severe headache. Neurological examination on admission revealed no deficits except for neck stiffness and somnolence. Computed tomography showed a subarachnoid hemorrhage, which was especially prominent in the supracerebellar and quadrigeminal cisterns, but demonstrated no ventriculomegaly. Cerebral angiography on admission revealed no apparent abnormalities, but repeat angiography 8 days later disclosed a saccular aneurysm (2×3 mm) arising from the hemispheric branch of the left superior cerebellar artery (SCA). Three days after admission, the patient developed cerebellar dysarthria, which was assumed to be due to vasospasm. On the 24th day after admission, the aneurysm was successfully clipped through the infratentorial-supracerebellar approach. The postoperative course was uneventful and the patient was discharged with no neurological deficit. Nineteen other cases of peripheral SCA aneurysm have been reported in the literature. The presence of this type of aneurysm should be considered in patients who are fairly young and have focal neurological signs, such as third or fourth nerve palsy and/or cerebellar dysfunction. The prognosis for such patients is good, except in cases in which the neurological status is poor at the onset.
日本脳神経外科学会の論文
1989-06-15