神経外傷
Online ISSN : 2434-3900
症例報告
頭部外傷により中硬膜動脈瘤および中硬膜動静脈瘻を生じた1例
大石 龍矢打田 淳大野 貴之林 裕樹金井 秀樹
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2020 年 43 巻 1 号 p. 33-36

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We report a case of coil embolization for a patient who showed progressive growth of a traumatic middle meningeal artery aneurysm (TMMA) and dural arteriovenous fistula (dAVF).

A 56–year–old woman was transported to our hospital with, suspected high–energy trauma. Acute epidural hematoma and multiple bone fractures were seen on head CT, but CT angio­graphy (3DCTA) showed no obvious traumatic vascular injury. On the day after the injury, no obvious neurological deteriora­tion was observed. MRI was performed on the 7th day for head­ache and cerebral contusion, and a right pseudoaneurysm of the middle meningeal artery was found suspected to be TMMA. Cerebral angiography performed on the 10th disease day revealed a right dAVF in addition to the right TMMA. Coil embolization was performed on the lesion, after which the headache disappeared and the lesions disappeared on 3DCTA.

In cases where a skull fracture is observed due to high–energy trauma, TMMA should be considered, with screening for traumat­ic vascular lesions using noninvasive MRA or 3DCTA. In addition, traumatic vascular injury may progress and needs to be evaluated over time.

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© 2020 日本脳神経外傷学会
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