内頚動脈周囲に炎症性肉芽を合併した視神経血管圧迫症候群の1例

Optic Neuropathy Secondary to Compression by the Internal Carotid Artery Concomitant with an Inflammatory Granuloma:A Case Report

Ⅰ．はじめに

　動脈硬化性変化を生じた内頚動脈によって視神経が圧迫を受け視神経障害を来す症例報告は散見される^1,3-6,9)．眼科所見のほかに特徴的所見が乏しいため，確定診断には難渋する．

　今回われわれは，半年の経過で進行し，一側性の視神経障害で発症した，内頚動脈による視神経圧迫症候群を経験したので報告する．

　A 77-year-old man presented with a 6-month history of progressive right optic neuropathy secondary to compression by the ipsilateral internal carotid artery（ICA). We performed anterior clinoidectomy and optic canal unroofing. Subsequently, we wrapped the ICA with a polytetrafluoroethylene tape, pulled the vessel laterally, and sutured the tape to the dura mater at the anterior skull base for optimal decompression. An inflammatory mass lesion was observed around the ICA, which led to further compression of the optic nerve. Histopathological examination of the resected specimen showed an inflammatory granuloma. The patient's visual field deficit showed partial improvement postoperatively. Transposition using a tape might be an effective surgical alternative for compressive optic neuropathy.