一側搏動性眼球突出を呈した広範なDural Arteriovenous Malformationの1例

A CASE OF DIFFUSE DURAL ARTERIOVENOUS MALFORMATION AT OCCIPTAL REGION WITH PULSATING EXOPHTHALMOS

Ｉ．はじめに

　脳動静脈奇形は全脳腫瘍の約2％といわれ，臨床上しばしば遭遇する疾患である。しかし外頸動脈，椎骨動脈などの頭蓋外血管を流入動脈とし，横静脈洞あるいはS字状静脈洞に入る脳動静脈疲となるときわめてまれであり，しかもその原因としては外傷性のものの報告が多く，特発性のものはその性格も明らかにされていない。われわれは最近両側の外頸動脈，内頸動脈および甲状頸動脈幹領域における異常血管群より樹浄脈洞へ短絡を示す広範囲な動静脈痩で，しかも右搏動性眼球突出をも認める興味ある1症例を経験したので報告し，その病態および治療に関し若干の考察を加えた。

This case is 51 year old female suffering from headache, vertigo, unconsciousness and unilateral pulsating exophthlmos.

The broad arteriovenous fistulas at the region of Torcular Herophili which were fed from bilateralinternal and external carotid arteries, vertebral arteries and thyreocervical trunks were revealed angiographically.

This case is seemed to be the same one of the dural arteriovenous malformation reported by Newton.

Seven oprations aimed to the ligation of these afferent arteries were performed extra-and intra-cranially. Her condition has gradually improved.

The pathogenesis and treatment of this curious disease were discussed.