Intracerebral Hemorrhage From a Ruptured Pseudoaneurysm After STA-MCA Anastomosis : Case Report
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概要
- 論文の詳細を見る
A 43-year-old hypertensive male developed a pseudoaneurysm at the site of a superficial temporal artery(STA)-middle cerebral artery(MCA)anastomosis, causing massive intracerebral hemorrhage 5 years after the operation. He first experienced repeated transient ischemic attacks, and cerebral angiography disclosed complete occlusion in the cervical portion of the left internal carotid artery. STA-MCA anastomosis was performed, and the ischemic attacks stopped. Postoperative angiography confirmed patency of the anastomosis and good filling of the cortical branches of the left MCA. Five years after surgery, the patient suffered sudden onset of generalized convulsions and consciousness disturbance. Computed tomography disclosed a nassive intracerebral hemorrhage in the left frontoparietal region, and angiography revealed an aneurysmal dilatation at the site of the anastomosis that was not seen before. Emergency evacuation of the hematonma and clipping of the aneurysmal dilatation were performed. The patient recovered well and became ambulatory. Histological examination of the surgical specimen showed collagen tissue, indicating a pseudoaneurysm. Patients who undergo STA-MCA anastomosis, especially hypertensive patients, should be followed up by repeated magnetic resonance angiography to confirm the patency of the anastomosis and cerebral perfusion, and to detect the formation of pseudoaneurysms at the anastomosis site, which can cause fatal bleeding.
- 日本脳神経外科学会の論文
- 2000-08-15
著者
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横山 徹夫
浜松医科大学脳神経外科
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横山 徹夫
浜岡総合病院 脳神経外科
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横山 徹夫
市立御前崎総合病院 脳神経外科
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SUGIYAMA Kenji
Department of Applied Pharmacology, Graduate School of Medicine and Pharmaceutical Sciences, Univers
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NISHIZAWA Shigeru
Department of Neurosurgery, University of Occupational and Environmental Health
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YOKOYAMA Tetsuo
Department of Neurosurgery, Hamamatsu University School of Medicine
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YOKOTA Naoki
Department of Neurosurgery, Hamamatsu University School of Medicine
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横山 徹夫
浜松医科大学脳外科
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Nishizawa Shigeru
Department Of Neurosurgery University Of Occupational And Environmental Health
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Nishizawa Shigeru
Department Of Neurosurgery Hamamatsu University School Of Medicine
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Nishizawa Shigeru
Departments Of Neurosurgery
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Yokota Naoki
Department Of Neurosurgery Hamamatsu University School Of Medicine
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Sugiyama Kenji
Department Of Neurosurgery Hamamatsu University School Of Medicine
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Yokoyama Tetsuo
Department Of Neurosurgery Hamamatsu University School Of Medicine
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Sugiyama Kenji
Department Of Applied Pharmacology Graduate School Of Medicine And Pharmaceutical Sciences Universit
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