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KMID : 0378019720150120163
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New Medical Journal
1972 Volume.15 No. 12 p.163 ~ p.166
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A Case of Cerebral Rete Mirabile with Aneurysm
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Abstract
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A 8 year old Korean boy was admitted to the Department of Neurosurgery, Seoul National University Hospital, because of unconsciousness and generalized convulsion. The past history was relevant in that the patient had experienced several episodes of the right sided weakness in the previous seven months. On the day of admission the patient suddenly complained of servere headache and became unconscious.´ He developed generalized tonic and clonic convulsions. On ´neurological examination the patient was semicomatose and irritable. The eyeballs were deviated toward the right side. There was no nystagmus. Right upper and lower extremities were hemiparetic. Deep tendon reflexes were markedly increased on both sides. Pathological reflexes were bilaterally present. Meningeal irritation signs were obviously noted. Cerebrospinal fluid revealed bloody. Bilateral carotid angiograms were done under general anesthesia and showed the angiographic appearance of typical cerebral rete mirabile with aneurysm: Rt. carotid angiogram showed both anterior and middle cerebral arteries with abnormal configuration and pathologial distribution. Lt. carotid angiogram demonstrated a distinctly pathological hemangiomatous vascular network at the base of the brain. The internal carotid artery was somewhat narrowed at Cz portion and both anterior and middle cerebral arteries were not visualized because of apparent occlusion at the initial portion near the bifurcation of internal carotid artery. From a branch of these abnormal vessels in the midline a small round aneurysm was visualized. Neither angiospasm nor hematoma was demonstrated.
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