肺動静脈奇形に起因したと思われる脳膿瘍の1例

Brain Abscess Secondary to Pulmonary Arteriovenous Malformation, Case Report

Ⅰ．はじめに

　脳膿瘍の原因としては種々のものがあるが，肺動静脈奇形に起因するものは稀で，これまでにも散発的な報告がみられるのみである^{1，3，5，6，8，9）}．本症例は脳膿瘍の、診断の下に病巣治療後，原因究明の過程で心臓陰影にかくれた肺動静脈奇形が発見された稀有な例である．

　左同側性半盲を主訴とした27歳男子で，右後頭葉に鶏卵大の脳膿瘍が見出された．これに対する外科治療後，その原因究明中に右肺下葉に肺動静脈奇形が発見され，これも外科的に別出され，治癒せしめることができた．

A case of brain abscess in the right parietal lobe secondary to pulmonary arteriovenous malformation of the right lung is presented. A 27-year-old man was admitted for headache and left homonymous hemianopsia. CAG, VAG and brain scan detected brain abscess of the right parietal lobe which was successfully removed surgically. He had been noted to have generalized cyanosis and club finger which corresponded to polycytemia and hypercapnia on examination. Subsequently pulmonary arteriovenous malformation was found in the right lower lobe of the lung which was also successfully excised by thoracic surgeons.