Endovascular Ligation後に水頭症の悪化を来した血栓化巨大脳動脈瘤の一例

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We presented a case of a 62-year-old female who had a giant thrombosed PCA aneurysm that showed progressive hydrocephalus after endovascular ligation. The patient presented with gait instability and came to our hospital. Brain CT and MRI revealed mass lesion with partial calcification which located in dorsal midbrain. We found giant thrombosed aneurysm of PCA by angiography. We performed Endovascular parent artery ligation. After operation, the patient had gradually deteriorated consciousness disturbance and gait instability. Brain CT and MRI demonstrated the increased the size of aneurysm which caused the dilatation of the ventricle, therefore, we performed endoscopic third ventriculostomy. Post operative course is uneventful, the patient recovered from her symptoms. Neuroimaging study exhibited decrement of aneurismal size. Endovascular treatment is useful for distal PCA aneurysm. Careful observation is needed after coil embolization for distal giant PCA aneurysm because of the complication of its mass effect. This case and a review of the literature are discussed
2003-03-01