内頸動脈閉塞症の1治験例—特に星状神経節遮断の治療的意義について

A CASE OF INTERNAL CAROTID ARTERY OCCLUSION TREATED BY STELLATE GANGLION BLOCK

1．緒言

　内頸動脈閉塞症に関しては，既に1872年Kuss-maul^1）の報告があるが，1937年Moniz^2）の脳血管撮影法の導入以来，本疾患の報告は次第に増加しつつある。然しその治療に関しては，未だ決定的なものはなく，血栓摘出^3），血管切除又は結紮^4），血管吻合移植^5）6）7），頸部交感神経切除^8）9）等の外科的療法，及び星状神経節遮断^{4）10）11）}，抗凝固剤使用^9）等が行われており，なお模索の状態にある様に思われる。

　最近，桂外科教室に於いて，頭部雑音を主訴として来院した左内頸動脈閉塞症の1例を経験したが，その治療法として星状神経節遮断を反復施行して自覚症状を完全に消退せしめ，後日の脳血管撮影により閉塞動脈の開通を他覚的に確認し得たので，文献的にこの症例を検討すると共に，星状神経節遮断の治療的意義に就いても考察を加えた。

There is increasing of number of the intern-al carotid artery occlusion in recent reports.

Concerning of the treatment, there seems no definite conclusion of the method. The treatment method should vary with the region of occlusion, pathogenesis, severity and durat-ion of its symptoms.

A patient, 20 aged farmer, who complained head noise chiefly was admitted to the Katsura's surgical clinic and treated with repeated stellate ganglion block. During and after the ganglion block, head noise was completely faded away and a cerebral angio-graphy showed reopening of the occlusionwhich was noticed before the performance of the stellate ganglion block.

It comes to conclusion that the occlusion of the internal carotid artery in this case seems likely due to angiospasm and repeated stellete ganglion block might be important method for the treatment in this case. We reported in this paper the evidence of reopening by repeated stellate ganglion block in the cere-bral angiography.