No shinkei geka. Neurological surgery
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Review Case Reports
[Ruptured internal carotid -posterior communicating artery aneurysm associated with an anomalous hyperplastic anterior choroidal artery and aneurysm: case report].
We report a rare case of a ruptured internal carotid-posterior communicating artery (IC-PcomA) aneurysm associated with an anomalous hyperplastic anterior choroidal artery (AchoA) and aneuysm. A 64-year-old woman was admitted to our hospital because of a sudden onset of headache. CT scan showed subarachnoid hemorrhage. ⋯ Postoperative left internal carotid angiograms demonstrated no aneurysm was observed at the IC-PcomA region. The patency of the fetal type PcomA and an anomalous hyperplastic AchoA were preserved. The 7 reported cases of a intracranial aneurysm associated with an anomalous hyperplastic AchoA with our case are reviewed and their neuroradiological and clinical features are discussed.
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Intra-arterial infusion (IA) of fasudil hydrochloride for cerebral vasospasm is performed in many institutions and is associated with few side effects. Nonetheless, as optimum dose and duration of action remain unknown, the present study aimed to clarify these variables. We performed intra-arterial injection of fasudil hydrochloride for eight patients with cerebral vasospasm 7-13 days after subarachnoid hemorrhage. ⋯ Average CBV (ml/100g) was 2.72 +/- 0.21, 2.73 +/- 0.21, 2.91 +/- 0.42, respectively and average MTT (sec) was 5.16 +/- 0.38, 4.57 +/- 0.70, 5.55 +/- 1.0, respectively. Changes in peripheral vessel diameter and in MTT were statistically significant. Therefore, when performing intra-arterial administration of fasudil hydrochloride, clinicians should be aware that vasodilator effect is less than 6 hours.