경동맥 협착과 동반된 미파열 전뇌동맥 동맥류 - 증례 보고 -
Symptomatic Carotid Stenosis and Unruptured ACA Aneurysm - Case Report -
소속 상세정보
김태호/Tae Ho Kim
권오기/이상형/한대희/정천기/김현집/O Ki Kwon/Sang Hyung Lee/Dae Hee Han/Chun Kee Jung/Hyun Jib Kim
KMID : 0359819980270010118
Abstract
서론
경동맥 협착증 환자에서 두개강내 동맥류가 발견되는 경우는 비교적 드문 예로 약 5%의
빈도로 발견되고 있다. 이 경우 치료방침을 결정하는 데 있어 여러 문제점이 있다. 문헌에
보고된 바로도 경동맥 내막 절개술만 시행하거나, 동맥류 결찰을 추가로 하거나, 동시에 두
가지 수술을 모두 하는 것을 귄유하고 있고, 수술을 하지 않고 관찰만 했던 경우도 있었다.
저자들은 일과성 뇌허혈, 경동맥 협착증, 그리고 동맥류가 동반된 환자를 치험하였기에 치료
방침에 관한 문헌 고찰과 함께 보고하고자 한다
#초록#
We describe the case of a patient with symptomatic left cervical ICA stenosis and
aneurysm of the left distal anterior cerebral artery. She presented with chronic headache
and recurrent attack of right hemiparesis and underwent staged operations. Using the
interhemispheric approach, the intracranial aneurysm was clipped. and there was no
postoperative neurologic deterioration. Two months later, a carotid endarterectomy was
performed. The patient recovered without complications and angiography revealed relief
of carotid stenosis and an unruptured intracranial visualization of the aneurysm. The
coexistence of symptomatic carotid stenosis of the internal carotid artery may increase
the pressure and turbulence to which the aneurysm is subjected, while the intracranial
approach to an aneurysm, when blood flow is decreased by carotid stenosis, may also
involve increased risk. In view of the theoretical risk of increased blood flow and
turbulence after carotid endarterectomy, aneurysm neck clipping followed by this
procedure either in a single stage or separate stages seems to be the another safest
management strategy.
키워드
Carotid stenosis; Intracranial aneurysm; Carotid endarterectomy;
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