MRIで部分的血栓化が証明されたSpinomedullary JunctionのRadiculomeningeal Arteriovenous Fistulaの1例

Partially Thrombosed Radiculomeningeal Arteriovenous Fistula in Spinomedullary Junction

I．はじめに

　脊髄動静脈奇形についての報告は，数多く見られるが，延髄前面にまで延び，多彩な症状を示した1症例を経験した．本例のごとく，MRIにより，血管撮影では造影されない血栓化した血管奇形と，延髄自体の変化を証明した報告はまだ少なく治療上の問題点とも関連して，文献的考察を加えて報告する．

A 58-year-old man was admitted to our hospital be-cause of tetraparesis of fairly sudden onset. He had had difficulty in miction since 6 months earlier.

MRI study showed a high intensity area in front of the medulla and a low intensity "vessel-like" shadow in front of the upper cervical region on TI-weighted im-age. The dorsal part of the medulla and cervical spinal cord showed diffuse low intensity signals in Tl-weighted image. The intra-axial lesion appeared as high intensity signals in T2-weighted image.

Angiography revealed a huge dilated vascular mal-formation fed by a third part of the right vertebral artery.