Feederの高度狭窄ともやもや様血管網を伴った脳動静脈奇形の1例

A Case of Arteriovenous Malformation Associated with Moyamoya Phenomenon

　Ⅰ．はじめに

脳動静脈奇形（arteriovenous malformation; AVM）は，動静脈シャントによるhigh flowがhemodynamic stressを関与する血管構築に与えることにより，様々な変化を及ぼす^2,13)．今回，feeding arteryの高度狭窄があり，もやもや血管網を介してfeedingされる稀なAVMを経験した．その病態，治療方針について考察を加え報告する．

　A case with arteriovenous malformation (AVM) associated with moyamoya phenomenon is reported. The 44 year-old female patient was presented with headache and vomiting. Computed tomography (CT) scan showed intraventricular hemorrhage. Cerebral angiography showed right frontal AVM and severe stenosis of right internal carotid artery. The AVM was fed by typical moyamoya vessels,Heubner's artery,and external carotid artery (ECA). We tried to embolize a bleeding point,compartment attached to lateral ventricle,but we could not. So,we embolized feeders from ECA and sent the patient to radiosurgery. We discuss here treatment and etiology of such rare condition.