Neurological Surgery 脳神経外科45巻12号

2017年12月発行

症例

左椎骨動脈の窓形成部に解離性破裂脳動脈瘤を生じた1例

著者： 高原健太¹ 天野敏之¹ 鶴﨑雄一郎² 古賀統之² 村尾惠² 有廣昇司² 山口慎也³ 芳賀整¹

所属機関： ¹九州労災病院脳神経外科 ²九州労災病院脳血管内科 ³製鉄記念八幡病院脳神経外科

ページ範囲：P.1075 - P.1080

Ⅰ．はじめに
　頭蓋内血管における窓形成（fenestration）の発生頻度は，主に2-dimensional digital subtraction angiography（2D-DSA）で評価されていた時代には，0.03〜1.3%と報告されていた^7,14,17)．しかし近年の目覚ましい神経放射線診断機器の発達により，3 teslaのmagnetic resonance angiography（3T-MRA），computed tomography angiography（CTA），3D-DSAなどのモダリティを使用した評価では，その発生頻度が3〜28%とも言われており，実臨床で遭遇する機会は増えてきている^{2,4,6,8,16,20)}．しかしながら，頭蓋内血管の窓形成の臨床的意義についてはほとんど解明されていない．これまでの報告で，頭蓋内主幹動脈の窓形成と嚢状動脈瘤の合併例は散見されるが，解離性動脈瘤の合併例は極めて稀な病態である．今回われわれは，左椎骨動脈（vertebral artery：VA）の窓形成部に解離性破裂脳動脈瘤を合併した症例を経験したため，若干の文献的考察を加え報告する．

参考文献

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