BRAIN and NERVE－神経研究の進歩63巻1号

2011年01月発行

特集 血管腫

海綿状血管腫に対する定位放射線治療の現状

著者： 四方聖二¹ 林基弘²

所属機関： ¹三愛病院さいたまガンマナイフセンター ²東京女子医科大学脳神経外科

ページ範囲：P.41 - P.49

文献概要

はじめに

　海綿状血管腫（cavernous malformations：CMs）はcavernous angiomas，cavernomas，cryptic vascular malformationsとしても知られており，また従来angiographically occult vascular malformations（AOVMs）と分類されていたもののほとんどが海綿状血管腫であったと言われている^1）。中枢神経系海綿状血管腫は先天性脳血管奇形の一種として分類され，真の腫瘍性病変とは異なりその多くが臨床的におとなしい性格の病変と考えられている。しかし，新規に（de novo）病変が出現することや^2－4），経過中に増大・出血・退縮などのdynamicな変化を見せる病変でもあり，それに伴い頭痛，痙攣，脳出血，神経局所症状を呈する^2－5）。一部の症例では繰り返す出血のために不良の転帰をたどることもある^6，7）。近年MRIなど検査機器の急速な普及により，無症候性で発見される頻度が高くなっており^8，9），本疾患の自然歴を解明し，それに基づく適切な治療方針を決定することの必要性が高まっている。近年いくつかの重要なレビューが相次いで報告され^10－12），海綿状血管腫の自然歴や定位放射線手術の有用性について包括的に理解する機会をわれわれに与えてくれることとなった。本稿では，これらを参考に解説を行っていきたい。

参考文献

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