Yoshiki Kenji, Misaki Kouichi, Nambu Iku, Fukui Issei, Mohri Masanao, Uchiyama Naoyuki, Nakada Mitsutoshi
Department of Neurosurgery, Division of Neuroscience, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan.
Case Rep Neurol. 2017 Nov 10;9(3):261-266. doi: 10.1159/000480425. eCollection 2017 Sep-Dec.
An unruptured aneurysm was incidentally found in the right middle cerebral artery in a 67-year-old woman. During an attempt to turn the temporalis muscle for surgical clipping, systolic blood pressure suddenly increased. After opening the dura mater, we found a subarachnoid hemorrhage and severe brain swelling. We promptly expanded the craniotomy area to reach the aneurysm while pulling part of the frontal lobe to apply a clip. We retrospectively analyzed the aneurysm using computational fluid dynamics. Our analysis suggests that the rupture of the aneurysm occurred at a location with very low wall shear stress.
一名67岁女性在右侧大脑中动脉意外发现一个未破裂的动脉瘤。在试图翻转颞肌进行手术夹闭时，收缩压突然升高。打开硬脑膜后，我们发现了蛛网膜下腔出血和严重的脑肿胀。我们迅速扩大开颅区域以暴露动脉瘤，同时牵拉部分额叶以夹闭动脉瘤。我们使用计算流体动力学对该动脉瘤进行了回顾性分析。我们的分析表明，动脉瘤破裂发生在壁面剪应力非常低的位置。
