Neurological Surgery 脳神経外科47巻9号

2019年09月発行

症例

後下小脳動脈延髄前部の窓形成に発生した紡錘状未破裂脳動脈瘤の稀な1例

著者： 中村光流¹³ 江端由穂¹ 日宇健² 近松元気¹⁴ 塩崎絵理¹⁴ 森塚倫也² 川原一郎² 小野智憲² 原口渉² 牛島隆二郎² 堤圭介²

所属機関： ¹国立病院機構長崎医療センター脳神経外科初期研修プログラム ²国立病院機構長崎医療センター脳神経外科 ³長崎県島原病院脳神経外科 ⁴長崎大学病院脳神経外科

ページ範囲：P.991 - P.997

Ⅰ．はじめに
　後下小脳動脈（posterior inferior cerebellar artery：PICA）における窓形成の報告は極めて少ない^10,12,15,17)．今回われわれは，PICA延髄前部（anterior medullary segment：AMS）の窓形成から発生した紡錘状未破裂脳動脈瘤の稀な1例を経験したので，文献的考察を加えて報告する．

参考文献

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4) Kumar S, Justin EM, Mishra NK：Fenestrated posterior inferior cerebellar artery with concomitant vertebro-basilar junction fenestration and vertebral artery aneurysm. Clin Neuroradiol 22：235-237, 2012

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10) Maeda K, Motoie R, Karashima S, Otsuji R, Ren N, Nagaoka S, Ikai Y, Uno J, Gi H：A case with coil embolization for ruptured aneurysm associated with fenestration of the posterior inferior cerebellar artery. Interv Neuroradiol 23：632-635, 2017

11) Padget DH：The development of the cranial arteries in the human embryo. Contrib Embryol 32：205-261, 1948

12) Pekcevik Y, Pekcevik R：Variations of the cerebellar arteries at CT angiography. Surg Radiol Anat 36：455-461, 2014

13) Rodríguez-Hernández A, Lu DC, Miric S, Lawton MT：Aneurysms associated with non-moyamoya collateral arterial networks：report of three cases and review of literature. Neurosurg Rev 34：517-522, 2011

14) Silva MA, See AP, Aziz-Sultan MA, Patel NJ：Surgical treatment of a double origin posterior inferior cerebellar artery aneurysm and insights from embryology：case report and literature review. Oper Neurosurg（Hagerstown）13：E8-E12, 2017

15) Singh R, Kumar R, Kumar A：Vascular anomalies of posterior fossa and their implications. J Craniofac Surg 28：2145-2150, 2017

16) Singh RK, Behari S, Kumar V, Jaiswal AK, Jain VK：Posterior inferior cerebellar artery aneurysms：anatomical variations and surgical strategies. Asian J Neurosurg 7：2-11, 2012

17) Theodosopoulos PV, Lawton MT：Fenestration of the posteroinferior cerebellar artery：case report. Neurosurgery 47：463-465, 2000