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Brain and Nerve No to Shinkei Volume 30, Issue 10 （October 1978）

Brain and Nerve 脳と神経 30巻10号（1978年10月発行）

Japanese English

原著

脳底部に"もやもや"血管網を示す疾患—その脳血管撮影とCTスキャンの検討 A DISEASE SHOWING"MOYA MOYA" VASCULAR NETWORK IN BASE OF BRAIN : EVALUATION OF ANGIOGRAPHY AND CRANIAL COMPUTED TOMOGRAPHY 宮坂和男 ¹ , 竹井秀敏 ¹ , 中川翼 ² , 阿部弘 ² , 都留美都雄 ² Kazuo Miyasaka ¹ , Hidetoshi Takei ¹ , Yoku Nakagawa ² , Hiroshi Abe ² , Mitsuo Tsuru ² ¹北海道大学医学部放射線学教室 ²北海道大学医学部脳神経外科学教室 ¹Department of Radiology, Hokkaido University School of Medicine ²Department of Neurosurgery, Hokkaido University School of Medicine pp.1083-1091

発行日 1978年10月1日 Published Date 1978/10/1

DOI https://doi.org/10.11477/mf.1406204317

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Abstract 文献概要
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I．はじめに

　脳血管撮影上，内頸動脈末端部，前および中大脳動脈近位部の狭窄，閉塞に併つて，脳底部に異常血管網を示す疾患は，"ウイリス輪閉塞症""脳血管もやもや病"などと呼ばれ，脳血管撮影の詳細な検討，および剖検例の積み重ねなどにより本症は動脈閉塞に随伴した側副血行路であるとする見方が次第に強くなりつつある^{2,6〜11,15〜17,20,21）}。

　しかしながら，このような像は，腫瘍^16），放射線照射^5），動脈硬化症^6），Von Recklinghausen氏病^5,11）などにおいても見られることが報告されており，脳血管撮影上の疾患群の中に，果して独立したClinico-pathologicalentityが存在するのかどうかという疑問は，依然として解明されていない。

Cranial computed tomography (CT) was carriedout in 7 cases which each cerebral angiogramshowed"Moya moya"vascular network in base ofbrain associated with intracranial arterial occlusion.CT and angiography were performed at same timeexcept one case without neurological deficit.Arbitararily we devided these cases into two groups;In one group, the possibility of intracranial arterialocclusion was anticipated because there were somerelating lesions such as neurofibromatosis and extra-cranial arterial occlusion with various etiology. Inthe other, such causal or related lesion was un-known.

However, define difference between two groupscould not be seen on CT except for formation ofangiographic transdural cortical anastomosis inlatter group; that is, CT in each group showedmultiple low density areas and localized wideningof cortical sulci suggesting ischemic brain lesion.

"Moya moya"vascular network was thought tohave some functions as collateral pathway becausethere were antegrade filling of some corticalbranches through it and little ischemic lesions inbasal ganglia on CT.

From the view point of correlation of angio-graphic collateral pattern and ischemic brain lesionon CT, next conclusions were obtained; Therewere little ischemic lesions in the region formingrich leptomeningeal anastomosis, while there weremore extensive ischemic lesions in the region de-pendent on mainly"Moya moya"vascular networkand/or transdural cortical anastomosis.

Therefore, latter two collateral pathways couldnot effectively replace leptomeningeal anastomosiswhen its parent artery might be occluded andocclusion of circle of Willis more widespread.