脳障害と治療

概要

Occlusion of an Incidentally-Found Dissecting Aneurysm of the Vertebral Artery at Removal of a Jugular Tubercle Meningioma

Yasuhiko Hayashi, Makoto Kimura, Akira Kinoshita and Jun-ichiro Hamada

This report presents a rare case of a 52-year-old female who had a left jugular tubercle meningioma with intratumoral hemorrhage and an adjacent dissecting aneurysm of Vertebral Artery (VA). The findings of neuroradiological images, such as fusiform dilatation and retention of contrast medium on angiogram and intramural hematoma on magnetic resonance imaging made a diagnosis of dissecting aneurysm. Because we speculated that the tumor was symptomatic and the dissecting aneurysm was not, only the removal of tumor was performed via lateral suboccipital craniectomy to result in total removal. Besides, intraoperatively, the intramural hematoma of dissecting aneurysm looked old and unruptured, we left it untreated. However, postoperative angiography revealed the occlusion of VA including the dissecting aneurysm. It was assumed the manipulation during the tumor removal altered the hemodynamics and promoted the thrombogenesis of VA with dissecting aneurysm.