Nō to shinkei = Brain and nerve
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Review Case Reports
[Dissecting aneurysm of the middle cerebral artery with subarachnoid hemorrhage undetectable on preoperative neuroradiological findings: case report].
We report a rare case of a dissecting aneurysm (DA) of the middle cerebral artery(MCA) associated with subarachnoid hemorrhage(SAH) undetectable on preoperative neuroradiological findings. A 64-year-old man was admitted to our hospital because of a sudden onset of occipital headache. CT scan showed SAH mainly in the basal cisterns and left sylvian fissure. ⋯ The postoperative course was uneventful and the patient was discharged without neurological deficits. There has been no rebleeding nor new ischemic attack during the ten months since surgery. The 20 reported cases of a DA of the MCA associated with SAH with our case are reviewed and their neuroradiological and clinical features are discussed.
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We describe here successful surgical treatment of a rare case of a rapidly enlarged aneurysm due to Takayasu's arteritis. A 22-year-old woman presented with a 1-month history of hoarseness and left neck pain. Contrast-enhanced computerized tomography showed an unruptured partially thrombosed aneurysm, and angiography revealed a large aneurysm of the common carotid artery. ⋯ Histological examination of the arterial wall showed inflammatory change, destruction of the medial elastic fibers, and granulation with multinucleated giant cells. The postoperative course was uneventful, and no new vascular lesion was observed 3 years after operation. We demonstrated the bilateral extracranial carotid artery aneurysms caused by Takayasu's arteritis, which was the first case to be reported in the literature.