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Neurological Surgery No Shinkei Geka Volume 18, Issue 12 （December 1990）

Neurological Surgery 脳神経外科 18巻12号（1990年12月発行）

Japanese English

症例

放射線治療が有効であった頭蓋内動静脈奇形の4例 Four Cases of Intracranial AVM Successfully Treated by Radiation Therapy 陳茂楠 ¹ , 今屋久俊 ² , 中沢省三 ³ Mau Nan CHEN ¹ , Hisatoshi IMAYA ² , Shozo NAKAZAWA ³ ¹佼成病院脳神経外科 ²東邦大学脳神経外科 ³日本医科大学脳神経外科 ¹Department of Neurosurgery, Kousei General Hospital ²Department of Neurosurgery, Toho University School of Medicine ³Department of Neurosurgery, Nippon Medical School キーワード： AVM , Dural AVM , Conventional radiation therapy , Radiosurgety Keyword: AVM , Dural AVM , Conventional radiation therapy , Radiosurgety pp.1161-1166

発行日 1990年12月10日 Published Date 1990/12/10

DOI https://doi.org/10.11477/mf.1436900186

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Abstract 文献概要
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I．はじめに

　Arteriovenous malformation（AVM）の治療法には外科的摘出術，流入動脈結紮術，塞栓術等いろいろの方法がある．放射線治療も古くから試みられている方法であるが否定的な報告が多かった^2-4,10,12）．しかし1960年のSvien and Peserico^18）の発表以来，本法が有効であるとする報告^{1,5,7,13,14,19,30）}が幾つかみられるようになり，再び注目されるようになった．近年Stereotactic gammaencepllalotomy（radiosurgery）^16）やBragg peak陽子線療法6）が試みられ，その有用性が報告されている．最近われわれは2例のdural AVMと2例のintracerebralAVMの計4例に放射線療法を行った．2例のduralAVMと術後の残存AVM 1例には高圧X線療法を，深部AVMの1例にradiosurgeryを行い，良好な結果を得たので報告する．

We have treated three patients with conventional radiotherapy and one with stereotactic radiosurgery and report the follow-up results.

Case 1 was of a 63-year-old woman who had a dural AVM in the right cavernous sinus. She was irradiated using 10MV X-rays with a total of 30Gy. Post irradia-tion angiography showed a complete absence of dural AVM.

Case 2 was of a 62-year-old woman who had a dural AVM fed by the left external carotid artery in the right cavernous sinus. Embolization by gelfoam was per-formed before irradiation. The irradiation was given with a total dose of 30Gy. Post irradiation angiography showed disappearance of the dural AVM.

Case 3 was of a 26-year-old woman who had a small AVM (about 20 X 15 X 15mm) in the posterior corpus callosum. An operation was performed but the AVM was not excised completely. We irradiated the residual AVM with a total of 30Gy. The follow-up angiography one year after treatment, showed disappearance of the AVM. She had no neurological deficit two years after the treatment.

Case 4 was of a 14-year-old boy who had a small AVM (about 20 X 15 X 10mm) in the left anterior wall of the fourth ventricle. The AVM was located deeply, so an operation was not performed. Radiosurgery was undertaken four months after onset in Buenos Aires. The total dose was 36Gy. The follow-up angiographyone year after treatment, showed disappearance of the AVM. He also had no neurological deficit two years af-ter the treatment. These four cases of AVM (two duralAVMs) were successfully treated by radiation therapy. No side effect was observed.