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Brain and Nerve No to Shinkei Volume 22, Issue 4 （April 1970）

Brain and Nerve 脳と神経 22巻4号（1970年4月発行）

Japanese English

特集脳血管障害

日本人に多発する脳底部網状異常血管像を示す疾患群の検討—Cerebrovascular"Moyamoya"Disease—第5報"Ethmoidal Moyamoya"について COLLATERAL PASS WAY VIA "ETHMOIDAL MOYAMOYA" IN CEREBROVASCULAR" MOYAMOYA" DISEASE: DISEASE SHOWING ABNORMAL NET-LIKE VESSELS IN BASE OF BRAIN 鈴木二郎 ¹ , 児玉南海雄 ¹ , 高久晃 ¹ Jiro Suzuki ¹ , Namio Kodama ¹ , Akira Takaku ¹ ¹東北大学脳研脳神経外科 ¹Division of Neurosurgery, Institute of Brain Diseases, Tohoku University School of Medicine pp.417-424

発行日 1970年4月1日 Published Date 1970/4/1

DOI https://doi.org/10.11477/mf.1406202705

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Abstract 文献概要
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Ｉ．はじめに

　脳底部に異常網状血管像を呈する疾患（第1図）については，われわれは昭和38年以来，ひとつの疾患単位となるのではないかとして追究してきた^{4）5）6）7）8）}。すなわちその発生は後天性のもので最初になんらかの原因によって，頭蓋内内頸動脈分岐部，前および中大脳動脈起始部の狭窄が起こり，その側副路として付近穿通動脈を中心とした血管が主体となって網状血管が発生してくるものであると繰り返し述べてきた。その他本疾患について現在まで主張してきた事項は第1表のごとくである。

　さて本疾患，特に若年者の脳血管側面像をみると脳底部にみられると同様な異常網状血管像（以下Moyamo—yaと呼称する）が眼窩内にもみられるのであり（第2図），この眼窩内Moyamoyaについてもすでに述べてきた。しかしはたしてこの眼窩内Moyamoyaがどんなもので，どんな意義を有するものかということについてはまつたく未検討であった。今回はこの眼窩内Moya—moyaについて検討したので報告し，ご批判をあおぎたいと思う。

About the cerebrovascular "Moyamoya" Disease (Disease showing abnormal net-like vessels in base of brain), we have reported the results of the in-vestigation from various points of view.

Almost of all, we have pointed out to find ab-normal net-like vessels not only in base of brain but also in orbit.

But the mechanisms of formation and the signi-fication of this abnormal net-like vessels in orbit have not been explained.

On this report, this abnormal net-like vessels in orbit is discussed.

(1) After the detailed investigation it was con-cluded that this abnormal net-like vessels in orbit are the dilated mucosal net-like vessels of ethmoidal sinuses and meatus nasi superior.

Therefore, this abnormal net-like vessels are named as "Ethmoidal Moyamoya".

(2) This "Ethmoidal Moyamoya", is suplied by the blood flow from ophthalmic artery of a branch of internal carotid artery and many branches of external carotid arteries via anterior and posterior ethmoidal arteries.

(3) It is thought that dilated olfactory artery, remnant artery of primitive ventral opthalmic artery and dorsal opthalmic artery run from this "Eth-moidal Moyamoya" to the abnormal net-like vessels in base of brain and fore brain through lamina cribrosa.

(4) In younger group of this disease, the rela-tionship of development between the "Moyamoya" in their two location is the contrary.

When the "Moyamoya" in base of brain decays, the "Ethmoidal Moyamoya" prospers.

(5) In adult group of this disease, as the deve-lopment of the "Ethmoidal Moyamoya" is poor, so it is suspected that most of them fell ill in their period of full age.

But it doesn't deny that some of the patients whose development of "Ethmoidal Moyamoya" is good fell ill in their young period and the progres-sion of the moyamoya in base of brain was stopped half way at a certain stage of this disease.