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I.はじめに
脳動静脈奇形(AVM)が,頭蓋内に複数存在することは稀であるとされており,症例報告が主であった.一方,大きなseriesにおける出現頻度は画像診断の進歩により次第に多くなってきつつある11,22,24).われわれが最近経験した症例においては,plexiform typeとarte—rio-venous fistula(AVF)の2つの形をとるAVMを脳内4ヵ所に認め,各々の間には介在する脳組織を認めた.この症例に対してstaged operationを施行して,完治せしめたので,若干の文献的考察とともにその臨床経過を報告する.
A ten-year old girl with right occipital multiple arte-riovenous malformations (AVMs) is reported.The cli-nical presentation at the onset of hemorrhage included coma and signs of tentorial herniation. CT after injec-tion of contrast medium revealed an inhomogenous en-hanced lesion in the right occipital lobe. Angiography demonstrated a large plexiform AVM and two AV fistu-las, each of which had a different arterial supply and different venous drainage. Three operations successful-ly removed all the AVMs. Operative findings indicated that the lesion consisted of 4 different AVMs. The pa-tient has recovered very well. Case histories and ther-apeutic and etiological considerations are discussed.
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