放射線照射後，頭蓋内主幹動脈の多発性閉塞及び狭窄を認めた1例

Complete Occlusion of Right Middle Cerebral Artery by Radiation Therapy after Removal of Pituitary Adenoma: Case report

I．はじめに

　脳腫瘍に対する放射線療法の効果は，現在広く認められている．一方その合併症についても，急性のものから遅発性のものまで種々知られており中枢神経系の血管に対するものは小血管病変を中心に数多くの報告がある．しかし，放射線照射後の脳主幹動脈の傷害に関する報告は比較的少ない．今回われわれは，放射線照射後，右中大脳動脈水平部の完全閉塞，両側の脳主幹動脈の多発性狭窄並びに，モヤモヤ様血管の新生をきたした1例を経験したので，若干の文献的考察を加え報告する．

Radiation angiopathy is a well-known complication accompanying irradiation. But the majority of effected vessels are small vessels. Cases of intracranial major arteries being effected are not so numerous.

We report the case of a 47-year-old female patient. The removal of pituitary adenoma was carried out on her in 1982. After that, 4500rad irradiation was per-formed. It was about six years after irradiation that thefirst angiography was made.

Right MCA occlusion, multiple stenosis of both ACAs and Moya-Moya like vessels were discovered.

On admission light paresis on her left lower extrem-ity was recognized and hyperlipidemia was noted. It was interesting that the multiple stenosis was found in an area outside the irradiation field. MCA-STA anastomosis was performed and the pro-gnosis was good.

The authors described this case and reviewed the pertinent literature.