小児の脳血管閉塞症例

THE OCCLUSION OF CEREBRAL ARTERY IN CHILDREN

I．はじめに

　近年，脳血管撮影の普及によつて，成人における脳動脈領域の毘閉塞性疾患については，かなり詳細な検索がなされてきている。しかし，小児について検討した報告は少なく，本邦では，清水^9），鬼頭^6）らによるごく少数の記載があるにすぎない。われわれは，脳血管撮影上，閉塞所見を呈した若干の小児例を経験したので報告する。

The number of reported cases concerned with the occlusion of cerebral artery in children is still scarce. In this paper, four cases of angiographically revealed occlusion of cerebral artery in children are discussed.

1) An 11-year-old boy had a sudden right hemi-plegia after the attacks of paroxysmal tachycardia. Carotid angiography revealed the occlusion of the left internal carotid artery at the end of the siphon.

2) A 6-year-old girl showed left hemiplegia. We have thought that it may be infantile cerebral palsy led by a severe asphyxia at her birth. In this case, arteriography revealed the poor filling of the branches pertaining of the right anterior cerebral artery and non-visualization of the ascending branches of the right middle cerebral artery.

3) A 6-year-old girl with right hemiplegia revealed angiographically a group of under-developed middle cerebral arteries. Diameter of the middle cerebral artery was finer than the other arteries. We have concluded that prenatal or embryonic disturbance of the middle cerebral artery may be the cause of this case.

4) A 7-month-old infant male, affected with cerebral abscesses, was thought angiographically to be the arterial occlusion of a larger branch of the right middle cerebral artery. But on autopsy, no occlusion was found, and there was a larger branch of middle cerebral artery split suddenly into a few fine branches. And thus we recognized that such a sudden splitting of larger arterial branch was difficult to distinguish from real arterial occlusion.