Ruptured Aneurysm at the Origin of the Median Artery of the Corpus Callosum Associated With Accessory Middle Cerebral Artery
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概要
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A 62-year-old male presented with ruptured anterior communicating artery(ACoA)aneurysm manifesting as severe headache associated with the rare combination of median artery of the corpus callosum(MACC)and accessory middle cerebral artery(MCA). Computed tomography demonstrated diffuse subarachnoid hemorrhage. Left carotid angiography demonstrated an anomalous vessel originating from the ACoA complex and passing forward in the interhemispheric fissure between the two companion A_2 segments. This vessel was identified as the MACC. Another anomalous vessel originated from the left A_1-A_2 segment and passed into the sylvian fissure. This vessel was identified as the accessory MCA. Left frontotemporal craniotomy was performed to clip the neck of the aneurysm. After identifying both A_1 and A_2 segments, accessory MCA, and the MACC, the aneurysm neck was occluded successfully. The ACoA complex is one of the most frequent sites of vascular anomalies. Preoperative and intraoperative care is required to identify the presence of anomalies of the ACoA complex prior to clip placement, to avoid accidental damage or clipping, which may result in severe neurological deficits.
- 日本脳神経外科学会の論文
- 2000-10-15
著者
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柴田 靖
秋本脳神経外科
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柴田 靖
北茨城市立総合病院
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柴田 靖
小川香料
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NOSE Tadao
Department of Neurosurgery, Institute of Clinical Medicine, University of Tsukuba
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柴田 靖
筑波大学大学院 人間総合科学研究科脳神経外科
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Yanaka Kiyoyuki
Departments Of Neurosurgery Institute Of Clinical Medicine University Of Tsukuba
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Yanaka Kiyoyuki
Neurosurgery Division Satte General Hospital
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Shibata Yasushi
Department Of Neurosurgery Institute Of Clinical Medicine University Of Tsukuba:(present Address)dep
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Shibata Yasushi
Department Of Neurosurgery Institute Of Clinical Medicine University Of Tsukuba:department Of Neuros
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Nose Tadao
Department Of Neurosurgery Institute Of Clinical Medicine University Of Tsukuba
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Nose Tadao
Department Of Neurological Surgery Insititute Of Clinical Medicine University Of Tsukuba
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Shirai Shizuo
Neurosurgery Division Soujinkai Hospital Ibaraki
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Shirai Shizuo
Neuro-psychiatric Dept. School Of Medicine Chiba Univ
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Yanaka Kiyoyuki
Neurosurgery Division Soujinkai Hospital Ibaraki;department Of Neurosurgery Institute Of Clinical Me
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SHIBATA Yasushi
Neurosurgery Division, Soujinkai, Hospital, Ibaraki
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Shibata Yasushi
Department Of Neurosurgery Kobari General Hospital:department Of Neurosurgery Institute Of Clinical
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Shibata Yasushi
Neurosurgery Division Soujinkai Hospital Ibaraki
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Yanaka Kiyoyuki
Neurosurgery Division Soujinkai Hospital Ibaraki;department Of Neurosurgery Institute Of Clinical Me
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