内頸動脈の閉塞を来した海綿静脈洞症候群の1例

CAVERNOUS SIUNS SYNDROME WITH A OCCLUDED INTERNAL ARTERY:SPECIAL REFERENCE TO NEURORADIOLOGICAL DIAGNOSIS

はじめに

　海綿静脈洞はトルコ鞍側方，蝶形骨洞上部に位置し，その中を動眼神経，滑車神経，外転神経，三叉神経等の脳神経および内頸動脈が貫通している。このため海綿静脈洞周辺の病変では種々の眼筋麻痺および前頭部，眼部痛等の三叉神経障害等が出現し海綿静脈洞症候群の名で総称され，この症候群そのものは日常時に遭遇する疾患ではある。

　その原因となる病変は頭蓋底部腫瘍，頸動脈海綿静脈洞瘻，床状突起下動脈瘤等多様であり，中でも動脈瘤，腫瘍，頸動脈海綿静脈洞瘻等によるものの報告は多い。一方，炎症による海綿静脈洞部閉塞の症例はそのほとんどが剖検所見によるものであり，病変部位をX線学的に確認したという報告はまずない。

Cavenous sinus syndrome is characterized by neurological deficits of III, IV, V, VI cranial nerves, and caused from various kinds of diseases arising at the cavernous sinus.

This condition can be frequently found, but there have been few report with refernce to neuroradio-logical diagnosis.

On this report, a case of inflammatory cavernous sinus syndrome with a occluded internal carotid artery was presented with the radiological diagnosis.

The case, 37 oear old male, was admitted to our hospital with complaints of right sided frontalgia and diplopia.

A pathological change suspecting inflammation was revealed at the sphenoidal sinus on a roulette tomogram, and then cavernous sinus thrombosis on the right side could be visualized by cavernous sinus venography we devised.

The advanced stenotic changes of cavernous portion of right internal carotid artery was revealed angiographically and the complete occlusion of the internal carotid artery was seen 6 months after admission.

Antibiotics and steroid hormone therapy were given to the case with good results.

The pathogenesis of this mild inflammation of cavernous sinus were also discussed.