Moyamoya病におけるTransdural anastomosis—Vault moyamoya

Transdural Anastomosis in Moyamoya Disease:Vault moyamoya

Ⅰ．はじめに

　Moyamoya病^16）に関し，われわれは1963年に1つの疾患単位となるのではないかと提唱し，その後各方面から検討を行い，脳底部moyamoya血管（以下basalmoyamoyaと呼称）の小児・成人間における消長の相違^16,19）や，その母体となる脳底部穿通動脈の血管構築上の特徴^6,9），小児・成人間の症状発現の差異^19）および症状発現機序^{7,10,11,13,21）}，ethmoidal moyamoya^17,20），小児におけ脳波所見^1,18），CT所見^3），そして外科的治療法^12,18）等につき報告してきた．

　さて，本疾患においては，脳血管写上basal moyamoyaおよびethmoidal moyamoyaと類似のmoyamoya血管が頭蓋穹隆部にも認められていたが（以下vaultmoyamoya），これまで未検討であった．今回はこのvault moyamoyaの出現部位，構成血管，basal moyamoyaの期相との相関等につき検討したので，若干の考察を加え報告する．

Transdural anastomosis in Moyamoya disease, which we have named as "Vault Moyamoya", is reported. It seems that these vault moyamoya vessels are apt to he developed at certain fixed positions; 9 definite places in children cases 6 in adults. Main feeding arteries of each vault moyamoya are dural arteries. In addition to them, the blood flow from STA and OA is found.

The incidence of vault moyamoya at each position shows similar tendency both in children and adults cases. Vault moyamoya are developed more frequently around the base of the brain near the carotid fork, where occlusion exists.