小脳内動静脈奇形の全摘例

ARTERIOVENOUS MALFORMATION OF THE CEREBELLUM : REPORT OF A CASE OF SUCCESSFUL REMOVAL

　35歳男子で，急激に発症した右小脳症候をきたした1例を報告した。椎骨動脈撮影で，右上小脳動脈を導入血管とし，直静脈洞そそぐ導出血管を有する小脳内動静脈奇形が発見され，右後頭開頭術でテントを開き，その全摘に成功した。

　後頭蓋窩脳動静脈奇形の外科的治療，特に，小脳内動静脈奇形に対する直接侵襲法について検討を加えた。

Arteriovenous malformation of the posterior fossa is rare. Surgical treatment for such malformation is variable according to its localization. Direct attack and total removal of the arteriovenous malformation of the cerebellum is feasible with the careful ap-proach. The authors removed the arteriovenous malformation of the cerebellum with transoccipital craniotomy and opening the tentorium.

The patient was 35 year old sailor, who suddenly developed occipital headache and cerebellar ataxia on the right side. Vertebral angiography displayed the malformation in the right cerebellar hemisphere, of which the feeding artery was superior cerebellar artery and the draining vessel flew into the straight sinus. Postoperative convalescence was uneventful.

The authors reviewed the literature and discussed about the surgical treatment for the arteriovenous malformations of the posterior fossa.