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Neurological Surgery No Shinkei Geka Volume 23, Issue 4 （April 1995）

Neurological Surgery 脳神経外科 23巻4号（1995年4月発行）

Japanese English

症例

著明な両側総頸動脈拡張性病変の1例 Marked Dilatation of Bilateral Common Carotid Artery:A case report 今泉俊雄 ¹ , 加藤孝顕 ¹ , 官尾邦康 ¹ , 青山真也 ² , 林えり ² , 高木陽一 ² , 柴田真吾 ² , 畔蒜正義 ² , 滝上善市 ² , 藤瀬幸保 ² Toshio IMAIZUMI ¹ , Takaaki KATOH ¹ , Kuniyasu KANNO ¹ , Shinya AOYAMA ² , Eri HAYASHI ² , Youichi TAKAGI ² , Shingo SHIBATA ² , Masayoshi ABIRU ² , Yoshiichi TAKIGAMI ² , Yukiyasu FUJISE ² ¹王子総合病院脳神経外科 ²王子総合病院内科 ¹Department of Neurosurgery, Oji General Hospital ²2nd Division of Internal Medicine, Oji General Hospital キーワード： Dilatation , Aortitis , Atherosclerosis , Common carotid artery , Cerebral infarction Keyword: Dilatation , Aortitis , Atherosclerosis , Common carotid artery , Cerebral infarction pp.365-369

発行日 1995年4月10日 Published Date 1995/4/10

DOI https://doi.org/10.11477/mf.1436901013

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Abstract 文献概要
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I．はじめに

　脳動脈拡張性病変は日常診療においては稀であるが，その原因として動脈瘤，動脈硬化症，結合織疾患^2,8），炎症性疾患^9,14），先天性疾患^12,15），FMD（fibromuscular displasia）^3）などが挙げられる．

　著明に拡張した総頸動脈に脳動脈瘤を合併した症例を中井らが本誌で発表したが^10），今回われわれも同様な総頸動脈拡張性病変を経験したので，文献的考察も加え報告する．

We reported a rare case of marked dilatation of the bilateral common carotid artery (CCA) associated with stenosis of the left middle cerebral artery (MCA).

A 64-year-old female was admitted with right hemi-paresis and dysarthria. She was hospitalized 2 years ago for cholecystitis. For 5 years, she has been under medical treatment for hypertension, diabetes mellitus, hyperlipidemia, cardiac failure associated with hyper-trophic cardiomyopathy, and atrial fibrillation.

Brain CT scan showed infarction of the left corona radiata. Angiography revealed marked dilatation of thebilateral CCA and the internal carotid artery (ICA), moderate dilatation of the innominate artery and the right subclavian artery, kinking of the right CCA, di-verticular outpouching of the left ICA, and stenosis of the right external carotid artery and the left MCA. Breast CT scan revealed moderate dilatation and marked calcification of the ascending aorta and the aor-tic arch.

Laboratory examination did not show any sign of in-flammation, rheumatoid factor (RA), antistreptolysis-O (ASLO) and antinucleotic antibody.

Based on the clinical course, radiological findings and laboratory data, possible diagnosis of the dilatation of the bilateral CCA was discussed with particular empha-sis on arteriosclerotic aneurysm and aortitis syndrome.