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Brain and Nerve No to Shinkei Volume 23, Issue 6 （June 1971）

Brain and Nerve 脳と神経 23巻6号（1971年6月発行）

Japanese English

研究

頭蓋内内頸動脈分枝に認められる動静脈奇形について ARTERIOVENOUS MALFORMATION OF THE VICINITY OF THE SYPHON OF THE INTERNAL CAROTID ARTERY 加川瑞夫 ¹ , 忍田欽哉 ¹ , 沢寿男 ¹ , 福田栄 ² Mizuo Kagawa ¹ , Kin-ya Oshida ¹ , Toshio Sawa ¹ , Sakae Hukuda ² ¹慶応義塾大学医学部脳神経外科 ²静岡赤十字病院脳神経外科 ¹Division of Neurological Surgery, Department of Surgery, Keio Univ. School of Medicene ²Shizuoka Sekijuji Hospital Department of Surgery pp.663-668

発行日 1971年6月1日 Published Date 1971/6/1

DOI https://doi.org/10.11477/mf.1406202916

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Abstract 文献概要
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はじめに

　脳主幹動脈をそのfeederとする動静脈奇形は頻度も多く，よく知られている。これに対して，有名微細動脈に認められる脳動静脈奇形は極めて少い。特に内頸動脈サイホン周辺から分岐する小動脈に生ずる動静脈奇形は極めて稀れであると言えよう。

　頭蓋内、内頸動脈から分岐する有名細動脈として主なものは，R．carotido-tympanicus,R．ca—nalis pterygoideus, R．　tentori basalis, R．　mea—tus acuticus internus, R．　clivi, R．　tentori ma—rginalis．　R．　Ganglion Gasseri, R．sinus cavern—osus, R．　meningicus, R．　hypoyhysii inferior etsupeior, A．　ophthahnica, A．　communicans po—sterior, A．　chorioidea anterior，と少くない。これら細動脈のうちA．chorioidea anteriorに生ずる動静脈奇形は稀れに認められ報告されているが，その他の小動脈に認められる動静脈奇形の報告はない。著者らはこれら細動脈のうちR．caro—tido-tympanicus, R．　cliviに認められたarterio—venous angioma 2例とA．　ophtalmica及びA．chorioidea anterior　に生じたVenous aneurysmを伴うarterio venous fistula 2例について若干の考察を加えて報告したい。

Arteriovenous malformation of the vicinity of thecarotid syphon is extremely rare.

We reported 4 cases with arteriovenous malfor-mation, in which the blood supply comes largely through branches of the internal carotid artery.

Case 1 is associated with arteriovenous fistula, in this case the blood supply comes through R. caro-tido-tympanicus and a branch of the middle menin-gial artery.

Case 2, microangioma, in this case the blood supply comes exclusively from R. clivi.

Case 3 and 4 are arteriovenous fistula with venous aneurysm, in case 3 main blood supply comes through the ophthalmic artery, in case 4 anterior choroidal artery is the main feeder.

The classification of the arteriovenous malforma-tion is still debated, arteriovenous malformation occurs due to maldevelopement of precapillary and capillary system, this maldevelopmental communi-cation between the arterial and the venous system occurs in three forms, there is a direct communi-cation between an artery and a vein, this from is extremely rare in the intracerebral arteriovenous malformation.

Case 3 and 4 show direct communication of an artery and a vein, this form is sometimes associated with venous aneurysm.

Case 2 shows another type of communication, in which a tangle of abnormal blood vessels of vary-ing caliber is interposed between the arterial and the venous system.

In this report, we disccussed 4 cases of arterio-venous malformation of the vicinity of the carotid syphon and intended to clarify angiographic classi-cation of arteriovenous malformation.