小児脳梗塞—6症例の検討

Clinical Analysis of Cerebral Infarction in Children

I．はじめに

　小児の脳血管障害の中でも脳血管閉塞病変はCTscanの普及にともない早期に診断されることが多くなってきた．しかし，成人と異なりその閉塞性疾患の原因は一様でなく，その病態もいまだ十分検討されていない．

　そこで，われわれは今まで経験した小児脳動脈閉塞性疾患（モヤモヤ病を除く）に関して，血管写を中心にその病態像を検討したので，若干の考察を加え報告する．

Abstract

Six cases of cerebral occlusive disease in children were reported. The cerebral arterial occlusive disease had its onset at the age of less than 4 years, except for one case of a 9 year-old. The causes of occlusion were, trauma in two cases, infectious disease in one case, in-traarterial myxoma in one case and an unknown reason in two cases. Initial symptoms were sudden onset of hemiplegia in 5 cases, and headache in one case. Angiography revealed stenosis of the main trunk of the middle cerebral artery, or of the anterior cerebral artery in 4 cases. Angiographical manifestations of stenosis in 4 cases were classified into two types, diffuse stenosis and localized stenosis. No stenotic changes were de-monstrated in two cases, in which CT revealed a small low density area in the putamen. Follow up angiogram in three cases revealed improvement of stenosis. Though therapy in all cases was conservative, their prognosis is not so poor as had been considered. As the rate of recanalization in children was assumed to be high as compared with adult cases, it was considered that surgical revascularization in the acute stage had to be undergone very carefully.