高血圧性小脳出血にみられたExtravasationとその臨床的意義

HYPERTENSIVE INTRACEREBELLAR HAEMORRHAGE WITH EXTRAVASATION OF CONTRAST MATERIAL. REPORT OF A CASE

はじめに

　近年，高血圧性脳出血急性例で，脳血管撮影上，造影剤の血管外漏出（Extravasation）を認めた症例の報告は増加しつつあるが^{1,5,8,9,14,17,18）}，高血圧性小脳出血において血管外漏出像をとらえた報告はみられない。著者等は過去3年間に手術，脳血管写，気脳写，剖検等で確認された13例の小脳出血を経験したが，このうち1例に連続椎骨動脈撮影によって，造影剤の血管外漏出像を認め，短時間の間，経時的に椎骨動脈撮影を行なうことにより，造影剤漏出像の消長を追跡し，これが脳血管破綻による血腫形成の速度や様相，及び小脳出血における血管破綻好発部位などの推定に重大な示唆を与えてくれると考えられたので，この点につき若干の考察を行ない報告する。

Fifty-year-old-female with hypertensive cerebellar haemorrhage, in which intracerebellar extravasa-tion of contrast material has been revealed by serial vertebral angiography, was described herein in detail.

The angiographic findings of intracerebellar leakage of contrast material have not been reported until now. In this case, serial vertebral angio-graphies were carried out twice within 3 hours after onset and showed the extravasation in the territory of the lateral branch of superior cere-bellar artery. She was autopsied and intraparen-chymal haemorrhage in the right cerebellar hemi-sphere was found.

From the correlation of angiographic findings and volume of intracerebellar haematoma, it is sug-gested that intracerebellar bleeding might not been occurred continuously but intermittently.