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I.はじめに
硬膜動静脈シャント(以下dAVS)は,硬膜又は硬膜よりなる頭蓋内組織に発生した動静脈シャントと定義され,横・S状静脈洞部と海綿静脈洞部の2カ所に好発し,その他の部位に発生するのは稀である.又,多発性のdAVSの報告は数例のみである.われわれは,くも膜下出血で発症し,前頭蓋窩及び後頭蓋窩に同時に複数のdAVSを認めた極めて稀な症例を経験したので文献的考察を加えて報告する.
We present here an interesting case of multiple dural arteriovenous shunts (dAVS) in different locations at the same time. There have been very few reports on multiple dAVS.
A 63-year-old man was admitted with a sudden onset of headache and vomiting. CT scan showed a typical subarachnoid hemorrhage (Fisher Group 3). Cerebral angiogram (6 vessel study) revealed two dural arte-riovenous shunts at the same time. One was located on the anterior fossa fed by the anterior ethmoidal artery, and the other was located on the posterior fossa near the marginal sinus fed by the left ascending pharyngeal and occipital arteries. At first, transarterial embolization was peformed for dAVS located on the posterior fossa. Radical operation was performed for both anterior and posterior fossa dAVS. Both dAVS had disappeared on postoperative angiograms.
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