特発性血小板減少性紫斑病に合併した破裂前大脳動脈瘤の1例

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  • Ruptured Aneurysm Associated with Idiopathic Thrombocytopenic Purpura: A Case Report

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A 59-year-old woman was admitted for a transient loss of consciousness, vomiting and severe headache. She was alert without neurological deficit then, and brain CT showed SAH (Fisher group 3). Angiography was performed on day 4 and showed left anterior cerebral artery aneurysm. Her previous history was as follows: She had undergone platelet transfusion after a myoma uteri operation when she was 37 years old. At 54 years old, she was diagnosed with idiopathic thrombocytopenic purpura (ITP), and had been receiving prednisolone since then. On admission, her platelet count was low (4.6 × 104/μl). We selected delayed surgery, and first γ-globulin and prednisolone were used to improve the platelet count. The patient developed a transient monoparesis in her right leg about 1 week after admission, but this gradually disappeared. The aneurysm was clipped 2 weeks after admission. The postoperative course was uneventful. We discuss the treatment of ruptured intracranial aneurysm with ITP.

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