19. 海綿静脈洞部巨大動脈瘤に対する Trapping あるいは carotid ligation とSTA-MCA 吻合術の併用

概要

論文の詳細を見る
For cerebral aneurysm, the approved method of treatment is to clip the neck of the sac, but for aneurysm in certain positions or of large size, this method may prove impracticable. Three such cases of giant aneurysm at the cavernous portion of the internal carotid artery have recently been treated at this hospital. The initial symptom in all cases was disturbance of the ocular movement. Neurological findings on admission showed abducens nerve palsy in two cases and oculomotor nerve palsy in the third. CT scan after infusion of contrast media revealed a high-density area at the cavernous portion of the internal carotid artery in each case, and cerebral carotid angiography demonstrated a giant aneurysm at the cavernous portion with a diameter more than 25 mm. Gradual ligation of the internal carotid artery was performed with STA-MCA anastomosis in two cases and a trapping of the internal carotid artery with STA-MCA anastomosis in one. In two cases, the operation results were excellent and in the third quite good. Postoperative CT scan showed the formation of a thrombus in the cavernous portion. Finally, the pathogenesis of late ischemic events after trapping of the internal carotid artery with STA-MCA anastomosis was discussed.
The Japanese Society on Surgery for Cerebral Strokeの論文