―症例―三叉神経痛を伴う多発性脳動静脈奇形の1例

Multiple Arteriovenous Malformations of Left Parietal Lobe and Left Cerebellar Hemisphere with Symptomatic Trigeminal Neuralgia: A case report

I．はじめに

　中枢神経系にcapillary telangiectasisやcavernousangiomaがときに多発することは知られているが^13），脳内多発性脳動静脈奇形の報告は極めて少なく，本例を加え著者らが渉猟し得た限り，6例の報告をみるにすぎない^{3,14,15,18,20）}．

　われわれは左頭頂葉と左小脳半球に独立した2個のAVMsをもち，左椎骨動脈にfenestrationを合併し，さらに小脳半球AVMのmain feederである上小脳動脈（SCA）の拡張，進展に起因する左三叉神経痛で発症した極めて稀な多発性脳動静脈奇形の1例を経験した，これに対し．AVMsを二期的に摘出し，三叉神経痛にはvascular decompressionを行い，両者ともに根治せしめたので，症例を提示し，若干の文献的考察を加え報告する．

　The authors described a case of multiple arteriovenous malformations of the left parietal lobe and the left cerebellar hemisphere, and presented a review of literature.

　A 42-year-old right-handed man was admitted to our Dept. of Neurosurgery on October 20, 1983, with left facial pain and occipitalgia. He had an episode of subarachnoid hemorrhage ten years ago, however, its etiology was not clear at neurological examination. This brief episode of pain began on the left side of his face about 9 years ago and has been gradually increasing.