左椎骨動脈に頭側および環椎部窓形成をみた1症例

A CASE OF TWO FENSTRATIONS OF THE LEFT VERTEBRAL ARTERY

Ｉ．はじめに

　脳血管撮影で，椎骨動脈に窓形成（Fenstration, Fo—ramenbildung）が証明された報告は，本邦では現在まで15例を数えるにすぎない。牧ら^5）によれば，諸外国では剖検によるもの以外の報告をみていないという。最近われわれは，左半身不全麻痺と視力障害を訴えた症例に右後大脳動脈流域の循環不全を疑つて精査したところ，椎骨動脈の2カ所に，すなわち頭側部窓形成に加えて環椎部形成をも証明された1例を経験した。本邦でもかかる症例の報告をみていないので，文献的考察を加えて報告する。

A case of the two fenstrations of the left vertebral artery was herein reported in detail. A 66-year-old man was admitted to our clinic with the complaints of the left hemiparesis and the visual disturbance. Four-vessel angiography revealed the circulatory insufficiency in the region of the right posterior cerebral artery. Two fenstrations were demonstrated on the left vertebral artery, one at the level of the first cervical vertebral and the other just proximal to the basilar artery in the cranium.

Fifteen cases of the fenstration of the vertebral artery reported in Japan were reviewed. It was of interest that 9 of 15 cases were associsated with cerebral aneurysm or arteriovenous malformation.