【投稿論文：Case Report】 Primitive trigeminal artery variant（PTAV）を合併した破裂内頚動脈前壁血豆状動脈瘤の1例

A rare case of ruptured blood blister-like aneurysm（BBA） in the internal carotid artery（ICA） with persistent trigeminal artery variant（PTAV） is reported．The existence of PTAV required the formulation of a treatment strategy． A 61-year-old woman presented with severe headache due to a subarachnoid hemorrhage．Repeated angiography revealed BBA in the right ICA with PTAV．Balloon test occlusion demonstrated the angiographic and neurological tolerance to the parent artery sacrifice of both the ICA and PTAV．Parent artery occlusion through the internal trapping of ICA by coils from the tip of the aneurysm to the orifice of the PTAV was performed．Postoperative MRI revealed asymptomatic border zone infarction both in the right frontal lobe and cerebellum． Existence of PTAV in the BBA of ICA affects the treatment strategy．Arranged preoperative balloon test occlusion was needed in the treatment decision-making process of this complex aneurysm．