脊髄動脈瘤と後頭蓋窩硬膜動静脈奇形を併存した1症例

Spinal Artery Aneurysm Associated with Dural AVM of the Posterior Fossa:A case report

I．はじめに

　近年，選択的脊髄血管撮影の普及により脊髄の血管性病変の診断も決して困難ではなくなってきている．今回われわれはクモ膜下出血で発症した脊髄動脈瘤と後頭蓋窩硬膜動静脈奇形の併存した1例を経験した．脊髄動静脈奇形に併存する脊髄動脈瘤はそれほど稀なものではなく文献上6-20％に認められる^4,7,10）とされる．しかし，脊髄動脈に単独で動脈瘤が存在することは非常に稀である^1,17）．さらに本例は後頭蓋窩の硬膜動静脈奇形を合併しており，このような症例はわれわれの渉猟しえた範囲では文献上認められなかった．この稀な1例を呈示し，若干の文献的考察を加えて報告する．

Abstract

The incidence of an aneurysm of the spinal artery is extremely rare. Only several cases have been documented previously. Herewith, the authors present a patient with a ruptured aneurysm of the anterior spinal artery associated with dural AVM of the posterior fossa.

A 51-year-old male had a sudden onset of occipital headache and left shoulder pain. Lumbar puncture re-vealed bloody CSF. Angiography showed a saccular aneurysm, filling from the anterior spinal artery and du-ral AVM of the posteior fossa. Aneurysmal neck clip-ping and cauterization for nidus of dural AVM was performed successfully through suboccipital craniec-tomy with laminectomy of Cl and C2. The authors re-viewed the literature and discussed the features of the aneurysm of a spinal artery.