脊柱管の内外にわたる胸部動静脈奇形の1例—その手術的治療に関する考察

Surgical Treatment of the Thoracic Arteriovenous Malformation with Intraspinal and Extraspinal Niduses

Ⅰ．はじめに

　近年，Di Chiroら（1967）^3）によって開発されたselective spinal cord angiographyは，その技術的進歩により脊髄動静脈奇形spinal Cord arteriovenous malformation（以下spinal AVMと略記する）の正確な診断を可能にした．これによりspinal AVMの発見率は著しく向上し，またmicroscopic neurosurgeryの導入^15）と相俟って，令摘出術も少なからぬ症例に行いうるようになった^{5，20，24）}．

　しかるに，spinal AVMの中には神経脱落症状の代償なしには全摘の困難な一群が存在し，かかる症例に対しては，諸家によって．種々の治療方法が試みられてきている．

Resent advances in the technique of selective spinal angiography and microsurgery have provided us remarkable progress in diagnosis and treatment of spinal arteriovenous malformations. Although in some cases total extirpation is still difficult, various attempts have been performed for complete cure.

In this paper, the authors reported a case of 6-year-old girl who complained of the progressive gait disturbance. In this case we found the thoracic AVM which had niduses not only in the intraspinal canal but also in the extraspinal space. Transthoracic ligature was performed in this case.