Gamma knife療法にて治癒した多発性脳動静脈奇形の1例

A Case of Multiple Cerebral Arteriovenous Malformations Treated by Gamma Knife Radiosurgery

I．はじめに

　多発性脳動静脈奇形（multipre cerebral arteriovenous malformations，以下，多発性AVM）は稀な疾患^{1-17,19，21-26）}であり，単発性のAVMと同様に，直達手術^{1,3-7,9，11-17,19,25,26）}，塞栓術^2,8），gamma knife治療^3），あるいはこれらの組み合わせ^3,8,10），などにより治療されているが，それらの適応にははっきりと確立されたものはない．われわれは，全身痙攣を主訴とした多発性AVMの女性に，gamma knife治療を行い，2年で治癒した症例を経験した．多発性AVMの治療法について，文献的に考察を加えて報告する．

We reported a case of multiple cerebral arteriovenous malformations (AVMs) treated by gamma knife radio-surgery. A 6-year-old girl was admitted because of sys-temic tonic convulsion. At the first admission, we per-formed only vertebral angiography, which showed a 15 mm cerebral AVM. It was fed by the right posterior cerebral artery and drained into the great vein of Galen. Seven years after the first admission, the patient returned again with severe headache. Four-vessel cere-bral angiograms showed another 7mm AVM fed by the left frontopolar artery. We treated both cerebral AVMs by gamma knife radiosurgery. Follow-up angiograms performed 2 years after radiosurgery confirmed the dis-appearance of both AVMs. We then discuss treatment of multiple cerebral AVMs.