頭部外傷後の脳血管狭窄の考え方—症例報告と報告例37例の検討

Posttraumatic Cerebrovascular Narrowing:A case report and review of the literature

I．はじめに

　頭部外傷後に発生する脳血管の狭窄は臨床上稀ならず認められるが，その報告は決して多くはない．さらに，脳動脈瘤破裂後の脳血管攣縮についての病態解明は多岐にわたっているのに対し，頭部外傷後の脳血管狭窄についての考察はいまだに十分でない．今回，われわれは頭部外傷後に一過性に中大脳動脈狭窄を認めた症例を経験したので報告し，現在の外傷後脳血管狭窄に対する考え方について若干の文献的考察を加える．

We, neurosurgeons have sometimes confronted with the case of posttraumatic cerebrovascular narrowing or spasm. However, there have been few reports on the pathophysiology of the posttraumatic narrowingor spasm in comparison with those the spasm following the subarachnoid hemorrhage caused by the rupture of the aneurysm.

The authors report here a case of temporal lobe contusion who demonstrated cerebrovascular narrowing angiographically at the 21st days after head injury. This 53-years-old male was examined again by angiography one week after the above-described angiography and the narrowing disappeared.