両側内腸骨動脈より供血された脊髄硬膜外動静脈奇形の1例

Spinal Epidural Arteriovenous Malformahon fed by Bilateral Intenlal Iliac Arteries

　I．はじめに

　脊髄動静脈奇形のnidusは胸腰髄レベルに多く，仙髄レベルでは非常に稀である^9,12）．

　今回著者らは，直腸肛門機能障害にて発症し，L₂レベルまで上行する脊髄症状を呈したが，実際にはnidusはS₁レベルの硬膜外にあった動静脈奇形の1例を経験した，この動静脈奇形は，両側内腸骨動脈より導入血管を受けていた．本例の症状発現機序に考察を加え報告する．

A rare case of a spinal epidural AVM fed by bilateral internal iliac arteries is reported. The patient was a 50 years old female with symptoms of slowly progressive paraparesis and sensory disturb-ance below L-2 associated with sphincter disorders. Myelography disclosed a serpiginous filling defect at the lumbar region. Selective internal iliac arterio-grams disclosed an AVM fed by bilateral lateral sacral arteries. The nidus was excised totally, then a gradual improvement of those symptoms followed.

Reviewing the literature, only 9 cases of spinal AVM of this type have been reported.