【投稿論文：Case Report】 破裂末梢性前下小脳動脈瘤の1直達手術例

Distal anterior inferior cerebellar artery (AICA) aneurysms are rare, especially distal from the meatal loop. We report the case of a ruptured aneurysm, arising from the postmeatal segment of the AICA, treated successfully by neck clipping of the aneurysm. A 74-year-old woman was admitted to our hospital with sudden headache and nausea. On admission, neurological examination revealed no neurological deficits except for the right hemiparesis due to left thalamic hemorrhage in the past history. Computed tomography (CT) of the head showed a subarachnoid hemorrhage (SAH) on the basal cistern and intraventricular hemorrhage in the fourth ventricle. Three dimensional CT angiography (3D-CTA) detected an aneurysm on the postmeatal segment of the right AICA. The patient underwent neck clipping using the far lateral approach. After surgery, she had no newly developed neurological def icits, and the postoperative course was also uneventful. Although the endovascular treatment is an alternative method for the treatment of ruptured distal AICA aneurysms, direct surgical approach is effective to get more detailed information about the aneurysm.