Kanai H, Umezu M, Koide K, Hato M
Department of Neurosurgery, Kakegawa City General Hospital, Kakegawa, Shizuoka.
Neurol Med Chir (Tokyo). 2001 May;41(5):260-3. doi: 10.2176/nmc.41.260.
A 61-year-old male with hypertension presented with sudden onset of headache and nausea due to subarachnoid hemorrhage (SAH). He had two siblings with history of SAH due to ruptured intracranial aneurysms. Right carotid angiography on admission showed an anterior communicating artery aneurysm. At that time, the extracranial arteries were not examined. The aneurysm was clipped with no complications. A pulsating mass was palpable in the abdomen 37 days after the onset. Ultrasonography and computed tomography showed an abdominal aortic aneurysm with intraluminal thrombus, measuring 8 x 9 x 8 cm. Normal pressure hydrocephalus had already developed. The patient underwent elective abdominal aortic aneurysm resection before ventriculoperitoneal shunting. After shunting, he recovered fully. The present case indicates that unpredictable sudden enlargement of associated abdominal aortic aneurysm is possible in patients with ruptured intracranial aneurysms.
一名61岁的高血压男性因蛛网膜下腔出血（SAH）出现突发头痛和恶心。他有两个兄弟姐妹有因颅内动脉瘤破裂导致SAH的病史。入院时右颈动脉血管造影显示前交通动脉瘤。当时未检查颅外动脉。动脉瘤夹闭术无并发症。发病37天后腹部可触及搏动性肿块。超声和计算机断层扫描显示腹主动脉瘤伴腔内血栓形成，大小为8×9×8厘米。已经出现正常压力脑积水。患者在脑室腹腔分流术前接受了择期腹主动脉瘤切除术。分流术后，他完全康复。本病例表明，颅内动脉瘤破裂患者可能出现相关腹主动脉瘤不可预测的突然增大。
