中大脳動脈部分血栓化動脈瘤の2症例

抄録

Thrombosis of cerebral aneurysms increases the risk of rupture and may even lead to cerebral infarction due to the dispersion of thrombus. We describe two case reports for patients who underwent surgical treatment for a symptomatic partially thrombosed aneurysm of the middle cerebral artery (MCA).
Case 1 was a 20-year-old man who presented with a headache. Detailed examination revealed a partially thrombosed large cerebral aneurysm along the right MCA, which was enlarged owing to advanced thrombosis. The patient experienced subarachnoid hemorrhage while awaiting planned surgery and underwent emergency neck clipping of the aneurysm.
Case 2 was a 63-year-old woman who developed cerebral infarction following a right MCA aneurysm growth with thrombosis and underwent emergency coil embolization. She presented with a recurrent aneurysm 3 months later, and underwent a second coil embolization. Both cases showed acute transformation secondary to thrombosis. Urgent treatment is warranted when symptoms related to thrombosis are observed. The treatment strategy should be designed carefully to suit individual cases based on varying anatomy/geometrical patterns of aneurysms and varying progression of thrombosis.