左鎖骨下動脈および左中大脳動脈閉塞を呈した1症例

A CASE OF OCCLUSIONS OF THE LEFT MIDDLE CEREBRAL AND SUBCLAVIAN ARTERIES

緒言

　脳に血液を供給する動脈の閉塞性疾患のうち，Bürger病，特発性頸動脈閉塞症および脈なし病の異同，あるいは相互関係については多くの論議がなされている。

　とくに本邦においてはBürger病脳型は比較的稀な疾患とされ，脈なし病ほど多くの症例は報告されていない。

The interrelation of pathogenesis betweeen pulse-less disease and cerebral type of Bürger's disease had been discussed by many investigators, and the both disorders were concidered to be different entities respectively by the most of authors.

Here, the authors have presented a case of occlu-sion of the left middle cerebral and subclavian arteries. The case, 54 aged female had revealed i) loss of pulsation of the left radial artery, ii) hyper-sensitivity of the carotid sinus reflex, iii) left hemiparesis and iv) mental and emotional changes. Additionally observed increase in the rate of R. B. C. sedimentation led us to consider the conditions as pulseless disease.

Historogical findings of biopsy specimen from the occluded vessls, however, had revealed the charac-teristics of Bürger's disease, and not of pulseless disease.

The discrepancy between the clinical features and histological finding as pulseless disease might yield a concept of resemblance of pathogenesis to Bürger's disease.

The authors have discussed on the close relation-ship between Bürger's disease and pulseless disease from the experiences of our case and the findings of the pastly reported cases.