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I.はじめに
顔面痙攣は,顔面神経がその起始部(いわゆるexitzone)において圧迫されることにより発症し,その圧迫原因のほとんどが後頭蓋窩の小血管であるといわれている.Jannettaにより神経血管減圧術(microvasculardecompression,以下MVDと略)が確立されてから,その治療法は格段の進歩を遂げた.
今回われわれは,顔面痙攣で発症した脳動静脈奇形(以下AVMと略)症例を経験した.また,本症例は動脈瘤を合併しており,AVM摘出後には動脈瘤が消失した.この病態にはAVMのhemodynamic stressが強く関与していると考えられた.症例を呈示し,若干の文献的考察を加えて報告する.
A case of cerebellar AVM onset with hemifacial spasm was reported. The patient, a 47 year old woman, had been suffering from It. hemifacial spasm for 10 years, and she visited our hospital for operation. Preop-erative angiography revealed that there was an AVM in the It. cerebellar hemisphere fed by the It. SCA and the It. PICA. In addition, a non-ruptured saccular aneurysm was observed on the feeding SCA. The mi-crovascular decompression was performed and the AVM was removed, since the it. facial nerve had been com-pressed by this elongated and redundant PICA. After the operation, It. hemifacial spasm disappeared.
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