脳動静脈奇形を合併した椎骨脳底動脈瘤例の検討

抄録

Among 230 patients with vertebrobasilar aneurysms who were hospitalized in Chiba University Hospital and its affiliated hospitals, there were eight cases (3.5%) associated with arteriovenous malformation(AVM). Age: 40-63 years old (53.5±9.0 years). There were no patients in their 20's or 30's even in cases where the AVM was responsible for the bleeding. The age distribution seems to follow the natural history of aneurysms. Sex: Four males and four femdes. Responsible lesion: Intracranial hemorrhage occurred in seven cases and the responsible lesion was not determined in two cases. The AVM was responsible in four cases and the aneurysm in only one. Hemodynamic relation: Hemodynamic relation was considered angiographically in seven cases. Three aneurysms were located along the feeder to the AVM, two were at the origin of the feeder, and two were at the proximal artery to the feeder. Location of AVM: The AVM was located in a supratentorial space in four cases and in an infratentorial space in four cases. Treatment and outcome: Both lesions were surgically treated in five cases and all of the five patients made good recovery. Surgery was not performed in three cases; one of these patients recovered, one died, and one was not followed-up. Conclusion: The vertebrobasilar aneurysms associated with AVMs had very similar characteristics to those reported in the literature on anterior circulation aneurysms with AVMs.