脳卒中の外科
Online ISSN : 1880-4683
Print ISSN : 0914-5508
ISSN-L : 0914-5508
脳動脈瘤と内頸動脈系閉塞性病変の合併例の治療
鈴鹿 知直永井 肇間瀬 光人福岡 秀和高木 卓爾
著者情報
ジャーナル フリー

1988 年 16 巻 1 号 p. 42-46

詳細
抄録

There are some differences of opinion regarding the management of intracranial aneurysms associated with internal carotid occlusive disease. Therapeutic approaches, e.g. whether to operate or not to operate on an intracranial aneurysm and whether to operate on an intracranial aneurysm first or secondarily are discussed in this paper.
The authors have experienced eight cases with both intracranial aneurysms and internal carotid occlusive disease. Four of these patients had ischemic attacks and coexisting intracranial aneurysms. The other four presented symptoms referable to an aneurysm and significant carotid or middle cerebral artery stenosis or occlusion on angiography. Five of these patients first underwent successful clipping of the aneurysm and one patient first underwent carotid endarterectomy and then clipping of the contralateral IC-ophthalmic aneurysm. Post-operative minor ischemic complication was present in one patient who had transient ischemic attacks three times and showed unilateral carotid occlusion with ipsilateral moyamoya vessels and an asymptomatic contralateral saccular aneurysm on angiography. The other five patients did not suffer from significant ischemic complications.
When the blood flow is decreased by carotid stenosis or occlusion, an intracranial approach to an aneurysm has been thought to carry an increased risk. Advance of operative technique, anesthesia and brain protective agents is expected to lead to lower operative morbidity without mortality.
The authors recommend that a patients with an intracranial aneurysm in the anterior circulation associated with internal carotid occlusive disease should be treated by clipping of the aneurysm first, except where the patient has a symptomatic carotid stenosis and an asymptomatic IC-ophthalmic aneurysm on the contralateral side that may need the ligation of the internal carotid artery at aneurysm surgery.

著者関連情報
© 一般社団法人 日本脳卒中の外科学会
前の記事 次の記事
feedback
Top