Posterior fossa dural AVMの自然消失後にAneurysmの発生を認めた1例

Internal Carotid Aneurysmal Formation following Spontaneous Regression of the Dural Arteriovenous Malformation in the Posterior Fossa:A case report

I．はじめに

　Newton^11）らのいうposterior fossaのdural AVMと考えられる症例の自然消失例は文献上2例の報告をみるにすぎない．われわれは8年前にdural AVMと診断し外科治療を加えたが，再発し，くも膜下出血を契機に自然消失したと思われる症例を経験した．再発しやすく治療困難と老えられているこの部のdural AVMの消失理由を文献的に考察した．さらに，この症例では1.5年の経過で内頸動脈に真性脳動脈瘤の発生を確認し治療を行った．短期間での脳動脈瘤の発生確認も稀であり，これにおいても文献的考察を加えた．

The patient was first admitted on August 19, 1975 with 5 years' headache and tinnitus. Physical exami-nation revealed bruit over the left mastoid area. Left angiography, performed in August, 1975, revealed a dural arteriovenous malformation, which was supplied by enlarged left middle meningeal artery, occipital ar-tery, meningohypophyseal artery and superior cerebel-lar artery and was draining into the left sigmoid sinus. At the first operation, the left external carotid artery was ligated at the neck, and then coagulation of dural vessels was performed through left temporo-occipital craniotomy.