Neurological Surgery 脳神経外科33巻3号

2005年03月発行

総説

症候性未破裂脳動脈瘤

著者： 伊達勲¹ 徳永浩司¹

所属機関： ¹岡山大学大学院医歯学総合研究科神経病態外科学（脳神経外科）

ページ範囲：P.201 - P.211

Ⅰ．はじめに

　未破裂脳動脈瘤には，無症候性のものと症候性のものがあり，脳ドックなどの普及によって無症候性のものが発見される機会が増えている．一方，症候性の未破裂脳動脈瘤は，脳神経障害，痙攣，塞栓性脳虚血症状，脳の圧排による神経症状などを呈し，無症候性のものに比較して破裂する危険性が高い⁹⁰⁾ことから，外科的治療が必要となることが多い．筆者らはこれまで，症候性未破裂脳動脈瘤に関して，視力視野障害を呈したもの^{17, 20)}，海綿静脈洞部，硬膜輪近傍あるいは錐体部の巨大脳動脈瘤^18,19,21-23)などの自験例をまとめ，報告してきた．本総説では，これらの経験を含め，症候性未破裂脳動脈瘤に関して，頭痛，視力視野，動眼神経麻痺，海綿静脈洞，その他の脳神経症状，周囲脳への圧排，てんかん，脳梗塞などをキーワードに，文献をまとめる．なお，本稿では通常の囊状動脈瘤について述べ，解離性動脈瘤に関しては，紙幅の関係もありふれない．

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