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Neurological Surgery No Shinkei Geka Volume 22, Issue 12 （December 1994）

Neurological Surgery 脳神経外科 22巻12号（1994年12月発行）

Japanese English

症例

遺残動脈を有する脳血管障害症例の検討 Evaluation of Cerebro-vascular Diseases with Persistent Carotid-Basilar Anastomosis 原田薫雄 ¹ , 魚住徹 ¹ , 栗栖薫 ¹ , 隅田昌之 ¹ , 中原章徳 ¹ , 右田圭介 ¹ Kunyu HARADA ¹ , Tohru UOZUMI ¹ , Kaoru KURISU ¹ , Masayuki SUMIDA ¹ , Akinori NAKAHARA ¹ , Keisuke MIGITA ¹ ¹広島大学脳神経外科 ¹Department of Neurosurgery, School of Medicine, Hiroshima University キーワード： Persistent carotid-basilar anastomosis , Cerebro-vascular diseases , Magnetic resonance angiography Keyword: Persistent carotid-basilar anastomosis , Cerebro-vascular diseases , Magnetic resonance angiography pp.1153-1158

発行日 1994年12月10日 Published Date 1994/12/10

DOI https://doi.org/10.11477/mf.1436900952

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Abstract 文献概要
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I．はじめに

　胎生期には内頸動脈の原基であるprimitive internal carotid arteryと椎骨動脈の原基であるlongitudinal neural arteryの間に多くの動脈吻合枝が存在し，血液の供給がなされている．脳血管系はこれらの吻合枝が次第に消失することによりその完成をみるわけであるが，一部稀に生後まで胎生期遺残動脈として残存することがあり，各種血管障害，脳腫瘍等の診断において偶発的に発見される．今回，われわれは1987年から1993年の6年間に広島大学脳神経外科にて経験された胎生期遺残動脈に脳動脈瘤，脳動静脈奇形を合併した5症例の臨床的特徴について検討したので文献的考察を加えて報告する．

Five cases of cerebro-vascular diseases with carotid-basilar anastomosis were evaluated. Case 1:a 73-year-old female was diagnosed as having subarachnoid hemorrhage due to a ruptured aneurysm of the right in-ternal carotid artery-posterior communicating artery bifurcation and demonstrated that a left proatlantal in-tersegmental artery. Case 2:a 38-year-old female showed intraventricle hemorrhage due to arteriovenous malformation and showed left primitive hypoglossal artery. Case 3:73-year-old female was diagnosed as having subarachnoid hemorrhage due to a ruptured basilar top aneurysm and demonstrated that a right primitive hypoglossal artery. Case 4: a 29-year-old male with unruptured aneurysm of the left internal carotid artery-posterior communicating artery bifurca-tion, and right trigeminal artery was detected inciden-tally by magnetic resonance angiography (MRA). Furthermore, right proatlantal intersegmental artery was detected by conventional angiography. Case 5:a 76-year-old male was diagnosed as having subarachnoid hemorrhage due to a ruptured aneurysm of the anterior communicating artery. MRA showed the aneurysm and a primitive trigeminal artery.

No clinical symptom related with carotid-basilar ana-stomosis was detected. Magnetic resonance angiography (MRA) was useful for diagnosis of asymptomatic caro-tid-basilar anastomosis. Especially, axial view of MRA by time of flight method detected two cases of a primi-tive trigeminal artery. And coronal view of MRA by phase contrast method is useful for diagnosis of primi-tive proatlantal intersegmental artery. More asymp-tomatic persistent carotid-basilar anastomosis may be detected by MRA.