【投稿論文：Case Report】 くも膜下出血後正常圧水頭症に対して脳室心房短絡術が著効した多発性嚢胞腎血液透析患者の1例

Selection of shunt procedure for a patient on hemodialysis is difficult. We report the case of a 59-year-old woman who had been on hemodialysis for 11 years. End-stage renal dysfunction had developed as a result of polycystic kidney disease. She received coil embolization for a ruptured basilar aneurysm at 58 years old. She experienced no neurological deficits and remained living independently. One year after first coiling, she complained of sudden headache and displayed severe impairment of consciousness. CT showed subarachnoid hemorrhage（SAH） and acute hydrocephalus. Coil embolization was performed for rerupture of the basilar aneurysm and external ventriclular drainage. Right hemiparesis was seen as a sequla of SAH. Normal pressure hydrocephalus developed 3 months after coil embolization. We performed ventriculo-atrial shunt for hydrocephalus, as the abdomen was distended and no space was available to insert the shunt tube due to polycystic kidney. Motor function and mental condition were recovered after shunt operation. Ventriculo-atrial shunt remains a useful operation for patients with these conditions．