くも膜下出血で発症した前頭蓋底部の硬膜動静脈奇形の1治験例

Dural Arteriovenous Malformation in the Anterior Fossa with Subarachnoid Hemorrhage

I．はじめに

　特発性硬膜動静脈奇形は，横静脈洞およびS状静脈洞，それに海綿静脈洞部の2系路における発生が最も多く^5-7），それ以外における発生頻度は低い^1,3,4）．最近われわれはくも膜下出血で発症し，脳血管撮影により右側の前頭蓋底に小さいnidusがみられ，右前篩骨動脈を流入動脈，皮質静脈を流出静脈とする硬膜動静脈奇形の成人男性の1例を経験した．右前頭開頭により，硬膜外および硬膜内操作により手術を行い，良好な結果を得て元の職場に復帰している．この稀な硬膜動静脈奇形の1例について報告する．

Idiopathic dural arteriovenous malformation which occurs in the posterior fossa uses predominantly transverse and sigmoid sinuses. Cavernous sinus comes next and others are rather rare. However, we have recently experienced such a rare case which was operated on and cured completely. The malfor-mation was fed through the anterior ethmoid artery and drained to the cortical vein.

The case was a 36-year-old male and admitted in our clinic for having headache and nausea as the chief complaints. He was diagnosed suharachnoid hemorrhage due to the following findings: