小脳虫部より両側小脳半球にわたる巨大動静脈奇型全摘の1例

A SUCCESSFUL REMOVAL OF ARTERIOVENIOUS MALFORMATION OF THE ROSTRAL PART OF THE VERMIS EXTENDED INTO BOTH CEREBELLAR HEMIS-PHERES: REPORT OF A CASE

はじめに

　後頭蓋窩の動静脈奇型は，テント上のそれに比し比較的少ない疾患であり，そのうちでも一側小脳半球に存在するものが多く，脳幹部，あるいは両側小脳半球にわたって存在するものはきわめて少ないといわれている。

　その治療法としては，全剔出術がもつとも望ましいものであるが，しかし後頭蓋窩脳動静脈奇型に対する全剔出術成功例については，1932年Olivecronaが最初の報告を行なつて以来数える程にすぎない。

An operated case of 39 year-old man with a large walnut sized arteriovenous malformation of the rostral part of the vermis extended into both cerebellar hemispheres was reported. The arterio-venous malformation was mainly fed by the r - superior cerebellar artery. Direct attack and total removal of the arteriovenous malformation was performed successfully.

Sato reported a successful case of the total remo-val of arteriovenous malformation of the posterior fassa before, and our case may be the second in Japan.

We have reviewed the literature and discussed about symptoms of the arteriovenous malformation of the posterior fossa, angiographical findings and the operative method.