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くも膜下出血に対する脳血管内手術―脳底動脈先端部破裂動脈瘤に対してコイル塞栓術を施行した1例
松本 学, 五十嵐 豊, 渡邊 顕弘, 和田 剛志, 関 厚二郎, 恩田 秀賢, 布施 明, 横田 裕行
日本医科大学大学院医学研究科侵襲生体管理学
Neuroendovascular Therapy for Subarachnoid Hemorrhage Endovascular Coiling for a Ruptured Cerebral Aneurysm at the Tip of the Basilar Artery: A Case Report
Gaku Matsumoto, Yutaka Igarashi, Akihiro Watanabe, Takeshi Wada, Kojiro Seki, Hidetaka Onda, Akira Fuse and Hiroyuki Yokota
Department of Emergency and Critical Care Medicine, Graduate School of Medicine, Nippon Medical School
A 71-year-old woman was admitted to our critical care center because of disturbance of consciousness of sudden onset. Computed tomography showed a subarachnoid hemorrhage. Angiography revealed a ruptured cerebral aneurysm at the tip of the basilar artery. We performed endovascular surgery to prevent rebleeding. The aneurysm was embolized with Guglielmi detachable coils, and complete occlusion was achieved. The patient regained consciousness. Angiography on the 12th day revealed no recurrence of the aneurysm and no vasospasm due to subarachnoid hemorrhage. The patient was disoriented but retained normal motor, sensory, and verbal functions. She was discharged from our critical care center and was transferred to another ward for rehabilitation. The efficacy of endovascular coiling for ruptured cerebral aneurysms was proven by the International Subarachnoid Aneurysms Trial. Thereafter, aneurysmal subarachnoid hemorrhage has often been managed with endovascular treatment rather than neurosurgical clipping. Advanced skills are needed to perform both endovascular treatment and neurosurgical clipping.
日医大医会誌 2011; 7(2), 97-102
Key words
subarachnoid hemorrhage, endovascular surgery, endovascular therapy, cerebral aneurysm
Correspondence to
Gaku Matsumoto, Department of Emergency and Critical Care Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
E-mail：gakumotomatsu@infoseek.jp
受付：2011年1月13日 受理：2011年2月22日 |
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