くも膜下出血で発症した内頸動脈C2部解離性動脈瘤と考えられた1例

概要

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We report the case of a 40-year-old female patient who was considered to have had a dissecting aneurysm (DA) at the C2 portion of the internal carotid artery (ICA) as a cause of subarachnoid hemorrhage (SAH). She suffered from sudden headache and was admitted to our hospital on the next day after onset (Day 1). A CT scan demonstrated SAH in the basal cisterns and the right sylvian fissure, and her clinical condition was WFNS Grade 2. Four-vessel angiography showed no saccular aneurysms but an aneurysmal dilatation, 5.5 mm in diameter, with proximal and distal narrowing at the C2 portion of the right ICA. The aneurysm did not have a neck. DA as a cause of SAH was suggested. She could not tolerate the balloon Matas' test at the right ICA on Day 2, and underwent the common carotid ligation and continuous spinal drainage. After a month, she was discharged without neurological deficits. When an aneurysmal dilatation at this portion of an ICA producing SAH is demonstrated, it is important to distinguish DA from other aneurysms such as blood blister-like and saccular ones. DA of the intracranial ICA producing SAH is rare. We review 6 cases including ours and discuss diagnosis and treatment.
日本脳卒中の外科学会の論文
2000-09-30