前頭側頭開頭術後に中硬膜動脈の仮性動脈瘤を認めた１例

DOI
  • 梶原 遼
    日本大学医学部 脳神経外科学系 神経外科学分野
  • 熊川 貴大
    日本大学医学部 脳神経外科学系 神経外科学分野
  • 角 光一郎
    日本大学医学部 脳神経外科学系 神経外科学分野
  • 永岡 右章
    独立行政法人 国立病院機構 埼玉病院 脳神経外科
  • 神服 尚之
    独立行政法人 国立病院機構 埼玉病院 脳神経外科
  • 前島 貞裕
    独立行政法人 国立病院機構 埼玉病院 脳神経外科
  • 吉野 篤緒
    日本大学医学部 脳神経外科学系 神経外科学分野

書誌事項

タイトル別名
  • Pseudoaneurysm of middle meningeal artery after a frontotemporal craniotomy: Case report

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説明

<p>Pseudoaneurysm of the middle meningeal artery (MMA) is a rare entity and is generally associated with traumatic brain injury. We reported a case of pseudoaneurysm of the MMA after frontotemporal craniotomy. A 71–year–old female presented with headache and dizziness, and was diagnosed as having subarachnoid hemorrhage due to ruptured aneurysm of the anterior communicating artery. Clipping of the aneurysm was performed by frontotemporal craniotomy via a trans sylvian approach. At 25 days after the surgical procedure, 3D CT angiography (3D–CTA) revealed aneurysm of the MMA. Cerebral angiography was performed at 29 days after surgery, and a 4–mm aneurysm with pooling of contrast agent was observed in the posterior branch of the MMA. Rapid aneurysmal growth was observed when com­pared to the cerebral angiography performed on the 8th post­operative day for the purpose of evaluating cerebral vasospasm. The aneurysm was located within the craniotomy, and trapping was performed on the aneurysm at 33 days after surgery. The aneurysm was excised and submitted for examination as a patho­logy specimen. The defect in the arterial wall and spilled blood were lined by surrounding connective tissue, and a diagnosis of pseudoaneurysm was made. This case was considered as pseudo­aneurysm due to iatrogenic injury triggered by craniotomy. A few cases of pseudoaneurysm of the MMA have been described in the literature and are mostly associated with head injury, not iatrogenic. Since pseudoaneurysm has a high mortality rate after rupture, sufficient hemostasis of the MMA during surgery is required. Furthermore, it is important to perform imaging examinations due to the possibility of pseudoaneurysm.</p>

収録刊行物

  • 神経外傷

    神経外傷 43 (2), 75-79, 2020-12-20

    一般社団法人 日本脳神経外傷学会

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