特集 解離性動脈瘤―症 例
多発囊胞腎に合併し，急速に増大した破裂前大脳動脈解離性動脈瘤の1例
2019 年 47 巻 6 号 p. 419-422
詳細
2019 年 47 巻 6 号 p. 419-422
Intracranial saccular aneurysms are commonly associated with autosomal dominant polycystic kidney disease (ADPKD). However, intracranial dissecting aneurysms have rarely been reported. Here, we report a case of ADPKD associated with an intracranial dissecting aneurysm of the anterior cerebral artery. A 58-year-old female presented with a subarachnoid hemorrhage (SAH), and the angiography showed the pearl and string sign with a small bulge, suggesting rupture of the anterior cerebral artery dissection. She suffered from a second SAH on Day 9, and the angiography demonstrated that the enlargement of the bulge was an aneurysm. Subsequently, she underwent trapping of the right A1 segment together with aneurysm dissection, and the lesion was excised.
Histological examination showed disruption of internal elastic laminas not only in the aneurysmal portion but also in the parent artery (A1), resulting in a final diagnosis of dissecting aneurysm-induced SAH.
