上小脳動脈閉塞症候群を呈した脳動脈瘤および脳動静脈奇形の1例

ANEURYSM AND MALFORMATION OF THE SUPERIOR CEREBELLAR ARTERY PRESENTING SUPERIOR CEREBELLAR ARTERY SYNDROME REPORT OF A CASE

はじめに

　上小脳動脈閉塞症候群は同側の小脳症状と対側の痛覚，温度覚障害を主徴とし，橋上部外側にその主病変を認める症候群であり，1900年，G．Anton^1）によつて最初の報告がなされて以来，外国では既に20例以上の症例が報告されている。本邦でも近年約7例の報告がみられる^4）8）9）。われわれは最近くも膜下出血後，上小脳動脈閉塞症候群を呈し，脳血管撮影により興味ある所見を示した1例を経験したので報告し，併せて若干の文献的考察をする。

A forty-five-year-old female presented so-called superior cerebellar artery syndrome when she re-gained consciousness after typical clinical course of subarachnoid hemorrage.

A saccular aneurysms (10mm × 10mm) acompany-ing an arterio-venous malformation arising from the peripheral portion of the right superior cerebellar artery was found in vertebral angiography.

The direct intracranial operation was performed and the aneurysm was almost totally encased in the brain tissue, probably the trigonum lemnisci. The surrounding brain tissue appeared markedly yellow. However, there was no large hematoma nor soften-ing cyst.

Author consider that the main cause of so-called superior cerebellar artery syndrome of this case is due to direct tumoral compression by an aneurysm over the superior lateral portion of the pons, which is very unusual cause of this syndrome.