境界領域小脳梗塞によってすくみ足が増悪した脳血管性パーキン症候群の1例

Transient Exacerbation of Frozen Gait by a Border Zone Cerebellar Infarction in a Patient with Vascular Parkinsonism:A Case Report

　症例は80歳男性。多発性脳梗塞により潜在的な左不全片麻痺とともに，軽度のすくみ足および小刻み歩行を呈していた。経過観察中，すくみ足の著明な一過性増悪を呈し，その原因として新たに出現した上小脳動脈外側枝-内側枝間の境界領域小脳梗塞が考えられた。すくみ足の出現機序として黒質線条体系や前頭葉の障害が推測されているが，しばしばすくみ足を呈する脳血管性パーキンソン症候群の病態に小脳障害の関与を示唆する報告も散見される。本症例および文献的検討から，小脳もまたすくみ足の形成に重要な役割を果たしている可能性が考えられた。

We report an 80-year-old man with vascular parkin-sonism whose frozen gait was transiently worsened by a cerebellar infarction. Four months before his first admission, he was diagnosed with gastric and esopha-geal cancer at another hospital, where he had a partial remission by radiotherapy. Two weeks before admis-sion, left hemiparesis due to a lacunar infarction ap-peared, and he was transferred to our hospital for re-habilitation. Upon admission, he had minimum left hemiparesis and mild frozen gait caused by multiple cerebral infarctions. His condition was improved by physical therapy, and he became ambulatory.