日本医科大学医学会雑誌
Online ISSN : 1880-2877
Print ISSN : 1349-8975
ISSN-L : 1349-8975
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くも膜下出血に対する脳血管内手術―脳底動脈先端部破裂動脈瘤に対してコイル塞栓術を施行した1例
松本 学五十嵐 豊渡邊 顕弘和田 剛志関 厚二郎恩田 秀賢布施 明横田 裕行
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2011 年 7 巻 2 号 p. 97-102

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A 71-year-old woman was admitted to our critical care center because of disturbance of consciousness of sudden onset. Computed tomography showed a subarachnoid hemorrhage. Angiography revealed a ruptured cerebral aneurysm at the tip of the basilar artery. We performed endovascular surgery to prevent rebleeding. The aneurysm was embolized with Guglielmi detachable coils, and complete occlusion was achieved. The patient regained consciousness. Angiography on the 12th day revealed no recurrence of the aneurysm and no vasospasm due to subarachnoid hemorrhage. The patient was disoriented but retained normal motor, sensory, and verbal functions. She was discharged from our critical care center and was transferred to another ward for rehabilitation. The efficacy of endovascular coiling for ruptured cerebral aneurysms was proven by the International Subarachnoid Aneurysms Trial. Thereafter, aneurysmal subarachnoid hemorrhage has often been managed with endovascular treatment rather than neurosurgical clipping. Advanced skills are needed to perform both endovascular treatment and neurosurgical clipping.

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© 2011 日本医科大学医学会
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