進行性の小脳半球静脈還流障害を呈した後頭蓋窩硬膜動静脈瘻の1例

Posterior fossa dural arteriovenous fistula with progressive disorder of cerebellar circulation:case report

I．はじめに

　硬膜動静脈瘻（以下d-AVF）は，横—S状静脈洞と海綿静脈洞部に好発し，高率に静脈洞閉塞を合併することが知られている．今回われわれは進行性の小脳半球静脈還流障害を呈したtransverse-sigmoid sinus閉塞を合併した後頭蓋窩硬膜動静脈瘻を経験したのでここに報告する．

A rare case of posterior fossa dural arteriovenous fis-tula with cerebellar circulation disorder is reported. A 64-year-old male was admitted to a hospital with com-plaints of nausea, vertigo and mild headache. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed cerebellar infarction. Then, he was sent to our hospital. He had complaints of cerebellar signs and nystagmus. Cerebral angiography showed dural AVF of the posterior fossa and occlusion of the left transverse-sigmoid sinuses. Because his condition de-teriorated, embolization of the left middle meningeal artery, ascending pharyngeal artery and occipital artery was performed selectively on August 18. Subsequently, isolation of dural AVF was performed on August 19.After the operation he improved and was able to walk with a stick. Controlled angiography revealed the dis-appearance of dural AVF. This case suggested that AV shunt is essential for the progression of venous infarc-tion.