急性硬膜下血腫で発症した破裂海綿静脈洞内内頸動脈瘤の1例

概要

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Intracavernouscarotid aneurysm rarely causes SAH and is not considered to be a lifethreatening lesion, although it sometimes causes compression syndrome. Therefore, asymptomatic intracavernouscarotid aneurysm is commonly treated by observation rather than surgery in spite of the recent development of endovascular treatment. We describe a rare case with subdural hematoma caused by rupture of an intracavernouscarotid aneurysm. A 55-year-old woman was brought to our hospital because of sudden headache. CT scan showed a mass of high-density region at the left cavernous sinus with sign of empty sella. She was discharged as no other lesion was observed. A few days later, she was admitted again to our hospital because of sudden headache followed by coma. Her JCS level was 200 and GCS was 4 on arrival. CT scan revealed a subdural hematoma extending from the intrasellar and suprasellar region to the bilateral hemispheric areas. Angiograms showed a left intracavernouscarotid aneurysm 10 mm in diameter. Although embolization of the aneurysm was successfully performed and her JCS level recovered to Level 3 without further rupture of the aneurysm, she died from the complication of sepsis and DIG.
日本脳卒中の外科学会の論文
2002-09-30