Neurological Surgery 脳神経外科41巻3号

2013年03月発行

症例

Thoracocervical giant perimedullary arteriovenous fistulaの1例

著者： 山口慎也¹ 濱村威² 伊藤理³ 佐山徹郎² 下川能史² 松角宏一郎¹ 森岡隆人²

所属機関： ¹浜の町病院脳神経外科 ²九州労災病院脳神経外科 ³新古賀病院脳神経外科

ページ範囲：P.247 - P.253

Ⅰ．はじめに

　脊髄perimedullary arteriovenous fistula（PMAVF）は，広義の脊髄動静脈奇形の一型であり，前脊髄動脈や後脊髄動脈が脊髄表面でnidusを介さず脊髄静脈へのシャントを来すものである^1-6,8,9)．発症の病態としては，静脈圧の上昇による脊髄症状^4,5,8,19)やくも膜下出血^5,8,19)が一般的であるが，稀に静脈瘤や異常拡張した静脈によるmass effectのために脊髄の圧迫を来す場合がある．これらはgiant perimedullary arteriovenous fistula（GPMAVF）として報告^{3,4,6,7,9,10,12,14-17,20-25)}されている．

　今回われわれは，PMAVFの異常拡張した流出静脈が上部胸髄～頚髄を広範囲にわたって圧迫しprogressive myelopathyを来したthoracocervical GPMAVFを経験した．その臨床経過および治療に関して，文献的考察を加え報告する．

参考文献

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