Subtemporal ＆ Trans-Tentorial Approachにより摘出した脳幹部海綿状血管腫の1例

A Case of Cavernous Angioma Extended from the Ventral Part of the Pons to the Midbrain: Subtemporal and trans-tentorial approach

I．はじめに

　cryptic vascular malformationが原因と思われる脳幹部血腫に対する直達手術の報告は稀であり，しかも，手術例の血腫の存在部位はほとんどが第4脳室底剖の橋背外側である^{1,4,5,7,11,12,16,19）}．

　今回われわれは橋腹外側から中脳にかけての特発性脳幹部血腫を，keel form skin incisionを用いた側頭開頭^18）から，subtemoporal ＆ trans-tentorial approachにより，摘出に成功し，組織学的にcavernous angiomaとの診断を得た症例を経験したので，若干の文献的考察を加え報告する．

　The authors presented a surgically treated case of cavernous angioma extending from the ventral part of the pons to the midbrain.

　A 20-year old man was admitted to our service with left motor weakness, dysarthria and consciousness disturbance. CT scan revealed a round wellcircumscribed high density lesion in the pons and midbrain. This was diagnosed preoperatively as a criptic vascular malformation with hemorrhage. The right temporal craniotomy with keel form skin incision and subtemporal & trans-tentorial approach was performed in an attempt to remove the hematoma and the angioma.