Abstract
症例は36歳, 男性.突然, 激しい鼻出血をきたし, 前ショックとなった.CT, MRI, 血管造影が施行され, 左内頸動脈海綿静脈洞部に径約3cm大の巨大動脈瘤が確認され, 一部蝶形骨洞内に突出していた.STA-MCA anastomosis施行後, 左内頸動脈のproximal ligationを行った.術後, 特に神経脱落症状を認めず, MRI上も動脈瘤は血栓化した.本症例では, 頭部外傷の既往はなく, 真性動脈瘤の破裂により蝶形骨洞を介し, 大量鼻出血を呈したと考えられた.激しい止血困難な鼻出血の鑑別診断として, 内頸動脈瘤の破裂も考える必要がある.
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