Neurological Surgery 脳神経外科34巻6号

2006年06月発行

総説

もやもや病に対する外科治療の実際と要点

著者： 岩間亨¹

所属機関： ¹岐阜大学大学院医学系研究科神経統御学講座脳神経外科分野

ページ範囲：P.557 - P.564

Ⅰ．は じ め に

　もやもや病は最初に本邦で報告され⁶⁷⁾，日本語がそのまま病名として国際的に用いられている日本の脳神経外科医にとっては大変馴染みの深い疾患である⁶⁵⁾．その発生頻度は本邦において高く，発症の好発年齢に二峰性のピークがあり⁷¹⁾，小児期発症例の多くが脳虚血症状を呈するのに対し，成人発症例では約60％が脳出血で発症すること，啼泣や吹奏，息を吹いて熱いものを冷ますなどの過呼吸の際に脳虚血発作を起こしやすいことなどは広く知られている．かつては確定診断のために脳血管撮影が必要であったが，近年，MRI/MRAの発達により非侵襲的に診断が可能となり，もやもや病と診断され医療機関を受診する患者が増加しつつある⁷⁰⁾．しかしながら，その他の脳血管障害と比較すればもやもや病の頻度は低く，1人の脳神経外科医が経験する症例数は必ずしも多くないため，実際にもやもや病の症例に遭遇した際，治療方針の決定，治療の実施に当惑することも多いと思われる．本稿では，もやもや病に対する外科治療を概説するとともに，実際の治療に際して重要と思われる要点について述べる．

参考文献

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