前脈絡叢動脈損傷による外傷性脳出血の1例

A Case Report of Traumatic Hemorrhage from the Anterior Choroidal Artery

Ⅰ．はじめに

　外傷性基底核出血は稀な出血形態で，頭部損傷のCT検査の3.1％に存在していると言われ，小児例の報告が多い⁷⁾．しかし，それらは中大脳動脈の穿通枝である線状体動脈の損傷例が多く，前脈絡叢動脈損傷例は非常に稀である⁹⁾．われわれは，外傷性前脈絡叢動脈損傷により片麻痺，同名半盲と一過性の無言症，仮性球麻痺，幻視を生じた症例を経験したので文献的考察を加えて報告する．

　Traumatic hemorrhage from the anterior choroidal artery is very rare. A 74-year-old male was admitted to our hospital immediately after a traffic accident. CT on admission showed right intracerebral hematomas in the posterior limb of the internal capsule and the upper part of the right cerebral peduncle. Neurological examination revealed that the patient had left hemiparesis and transient mute, pseudobulbar sign and peduncular hallucination. The absence of hypertensive asymptomatic microbleeds in other basal ganglia supported the verdict of traumatic injury of the anterior choroidal artery. The tear mechanism of the anterior choroidal artery might have been caused by an impact to the parietal region directed toward the tentorium.