内頸動脈内膜剥離術後に瘢痕性内頸動脈狭窄を来した1例

A Case of Recurrent Internal Carotid Stenosis, after Carotid Endarterectomy, due to Strangulation by Scarring

I．はじめに

　最近，頸部頸動脈閉塞性病変に対する手術適応，手技に関する見解は，ほぼ確立されつつあると思われるが，手術に伴う合併症も数多く報告されており^2-4,12），安易に行うべきものではない．われわれは頸動脈内膜剥離術（CEA）後，周囲軟部組織の瘢痕収縮に伴い，顎二腹筋，舌下神経および外頸動脈枝による絞扼により頸動脈に再狭窄を来した症例を経験したので，文献的考察を加えて報告する．

A case of recurrent internal carotid stenosis, one year after carotid endarterectomy, due to strangulation by scarring composed of digastric muscle, hypoglossal nerve and a branch of external carotid artery (ECA) is reported in this paper.

A 34-year-old male suddenly became nauseated and developed right hemiplegia and dysphasia. He was admitted to a hospital, and the symptoms and signs im-proved gradually during a period of several weeks. A left carotid angiography, performed in another hospital, revealed a stenosis and wall irregularity around the highly-situated carotid bifurcation.