くも膜下出血を示した脳動静脈奇形における脳血管攣縮の検討

Cerebral Vasospasm after Subarachnoid Hemorrhage from Arteriovenous Malformation

I．はじめに

　脳動脈瘤破裂のくも膜下出血（以下SAHとする）に伴う脳血管攣縮（以下spasmとする）は普通にみられる病態である．しかしSAHを来たした脳動静脈奇形（以下AVMとする）においてspasmを示すことは極めて稀である．またその報告^7,9,11,12）も少ない．AVMによるSAHに伴うspasmにつき検討したので報告する．

Cerebral vasospasm after SAH from AVMs is rare. Only few reports have been made. Vasospasm was confirmed in 4 out of 13 patients with SAH from AVMs at the Sagamihara National Hospital in the past 5 years. The incidence of vasospasm following rupture of AVM is higher than those in previous reports rang-ing between 8 and 12 percent. This high incidence (31%) might be attributable to the timing from the last SAH attack until angiography. The existence of massive subarachnoid blood clots around the arteries of the circle of Willis is the most important factor causing vasospasm after SAH from AVMs.