脳静脈性血管腫の4例—その手術適応とCT診断の重要性

Four Cases of Cerebral Venous Angioma:With particular reference to the operative indication and the importance of CT diagnosis

I．はじめに

　従来，静脈性血管腫は脳血管奇形のなかでも比較的稀なものとされ，剖検でinci-dentalに発見される病理学的興味が中心であった．しかし近年高解像力CTの普及に伴い，その臨床報告が増加しつつあり，脳外科臨床面でも注目されるようになってきた，最近われわれは4例の静脈性血管腫を経験したので，臨床的意義ならびに文献的考察を加えて報告する．特にその特有な血管撮影所見およびCT像の特徴を述べるとともに，手術適応について考察を加えたい．

Four cases of venous angioma, one cerebral andthree in the cerebellum, are reported.

Case 1. A 50-year-old woman who had a suddenattack of headache and disorientation was admitted tothe Mitsui Memorial Hospital. Neurological exami-nation revealed slight disorientation, mild motoraphasis and right hemiparesis. Plain CT scan onadmission showed a left frontal hematoma. Leftcerebral angiomas demonstrated a caput-Medusae-like lesion which consisted of numerous small veinsand drained into one single enlarged vein. EnhancedCT scan taken 12 days after the attack demonstrated alinear enhancement next of the hematoma.