痙攣で発症した内頸動脈形成不全の1例

A Case Report of Hypoplasia of the Left Internal Carotid Artery Manifested as Convulsion Attack

I．はじめに

　内頸動脈の形成不全は非常に稀であり，脳虚血や頭蓋内出血により発症することもあるが，脳血管撮影や剖検により偶然に発見されることもある．われわれは，てんかん発作で発症した内頸動脈形成不全の1例を経験したので報告し，その発生機序，病態，治療について検討した．

A case of hypoplasia of the left internal carotid artery manifested as convulsion was reported. The features and embryological process were reviewed.

The case was that of a 25-year-old female who had been afflicted with repeated convulsion for 16 years. CT scan showed a dilated left posterior communicating artery. Cerebral angiography revealed abrupt narrowing of the left internal carotid artery from a few centimeters distal to the bifurcation of the common carotid artery and terminating at the C4 portion. The left cerebral hemisphere was supplied, through well-developed ante-rior and posterior communicating arteries. On the CT scan with the skull base bone as target, the left carotid canal was smaller than the right one. Single photon emis-sion computed tomogram using Xe showed a slightly low perfusion area in the left cerebral hemisphere. Frequent spike waves were seen on the electroencephalogram. Af-ter the left STA-MCA anastomosis, spike waves dis-appeared and the patient has been free from convulsion for 3 years.