{"title":"前大脳動脈近位部(A1)動脈瘤の臨床像と治療成績","authors":"政之 金森, 弘樹 高沢, 慎悟 米澤, 俊介 面高, 奉洋 川口, 宏 緑川, 達也 佐々木, 西嶌 美知春","doi":"10.2335/SCS.39.353","DOIUrl":null,"url":null,"abstract":"Aneurysms of the proximal anterior cerebral artery (A1) are rare. We investigated the clinical and angiographical characteristics, and treatment outcomes of A1 aneurysms by reviewing a total of 989 cases of ruptured or unruptured cerebral aneurysms treated with surgical clipping or coil embolization in our department and identified 12 cases of A1 aneurysms (1.2%), including 4 ruptured and 8 unruptured aneurysms. Three of the 4 patients with ruptured aneurysm were Grade IV or V in the classification of the World Federation of Neurosurgical Societies. Five of the 8 cases of unruptured A1 aneurysm were identified during examination for subarachnoid hemorrhage due to ruptured aneurysm at other sites. The A1 aneurysms were located on the proximal segment in 9 cases and projected posteriorly or superiorly in 11 cases. Symptomatic complications occurred in 2 of the 10 cases treated by surgical clipping: cerebral infarction of the genu of internal capsule causing transient motor aphasia in 1 patient, and visual field disturbance due to obstruction of a perforator originating from the A1 in the other patient. Considering the anatomical relationship, any perforator originating from the A1 should be carefully manipulated at surgical clipping.","PeriodicalId":131030,"journal":{"name":"Surgery for Cerebral Stroke","volume":"41 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"2011-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Surgery for Cerebral Stroke","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2335/SCS.39.353","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Aneurysms of the proximal anterior cerebral artery (A1) are rare. We investigated the clinical and angiographical characteristics, and treatment outcomes of A1 aneurysms by reviewing a total of 989 cases of ruptured or unruptured cerebral aneurysms treated with surgical clipping or coil embolization in our department and identified 12 cases of A1 aneurysms (1.2%), including 4 ruptured and 8 unruptured aneurysms. Three of the 4 patients with ruptured aneurysm were Grade IV or V in the classification of the World Federation of Neurosurgical Societies. Five of the 8 cases of unruptured A1 aneurysm were identified during examination for subarachnoid hemorrhage due to ruptured aneurysm at other sites. The A1 aneurysms were located on the proximal segment in 9 cases and projected posteriorly or superiorly in 11 cases. Symptomatic complications occurred in 2 of the 10 cases treated by surgical clipping: cerebral infarction of the genu of internal capsule causing transient motor aphasia in 1 patient, and visual field disturbance due to obstruction of a perforator originating from the A1 in the other patient. Considering the anatomical relationship, any perforator originating from the A1 should be carefully manipulated at surgical clipping.