雑誌文献を検索します。書籍を検索する際には「書籍検索」を選択してください。

Neurological Surgery No Shinkei Geka Volume 25, Issue 2 （February 1997）

Neurological Surgery 脳神経外科 25巻2号（1997年2月発行）

Japanese English

研究

後頭蓋窩硬膜動静脈奇形の組織学的検討 Histopathological examinations of dural arteriovenous malformations of posterior fossa 百次仁 ¹ , 六川二郎 ² , 山城勝美 ² , 石川泰成 ² , 奥山久仁男 ² , 戸田隆義 ³ Jin MOMOJI ¹ , Jiro MUKAWA ² , Katsumi YAMASHIRO ² , Yasunari ISHIKAWA ² , Kunio OKUYAMA ² , Takayoshi TODA ³ ¹沖縄県立宮古病院脳神経外科 ²琉球大学脳神経外科 ³琉球大学臨床検査医学講座 ¹Department of Neurosurgery, Okinawa Prefectural Miyako Hospital ²Department of Neurosurgery, University of the Ryukyus School of Medicine ³Department of Clinical Laboratory Medicine, University of the Ryukyus School of Medicine キーワード： dural arteriovenous malformation , posterior fossa , histopathology , sinus thrombosis , embolization Keyword: dural arteriovenous malformation , posterior fossa , histopathology , sinus thrombosis , embolization pp.137-142

発行日 1997年2月10日 Published Date 1997/2/10

DOI https://doi.org/10.11477/mf.1436901345

PDF(6944KB)

有料閲覧

Abstract 文献概要
1ページ目 Look Inside

I．はじめに

　脳血管撮影の普及に伴い硬膜動静脈奇形（以下DAVM）の診断は容易となり近年，多数の報告がなされている．静脈洞血栓症とDAVMの関連が論ぜられることが多いが，静脈洞血栓症がDAVMの原因とする報告^{3-5,8,12,13）}や逆に静脈洞血栓症はDAVMの結果であるとする報告^17,18）もあり意見の一致をみていない．われわれは術前塞栓術を施行後，手術的に摘出した静脈洞及びDAVMを組織学的に検討したのでDAVMの発生機序について考察を加えて報告する．

Two cases of dural arteriovenous malformation (DAVM) of the posterior fossa were presented and a histopathological examination was described.

After embolization of the feeding arteries, DAVMs of the posterior fossa were removed with the adjacent sinus. Serial sections of the surgical specimens showed an abnormal mass with dilated, tortuous vessels of varying diameters in the sinus wall, and partially hyali-nized connective tissue around the vessels. The elastic lamina of the sinus wall was interrupted and a mass of abnormal vessels developed into the subintimal layer of the sinus. Fistulas, about 200μm in diameter, were formed between arterialized dural veins and dural arte-ries which had obvious internal elastic lamina. An open-ing of the fistula of the abnormal vessel, 25μm in dia-meter, to the sinus lumen was also seen. No stage of organized thrombus could be seen in the sinus lumen. These findings strongly suggested that physiologically existing arteriovenous fistulas within the dura mater, which have been reported by Kerber et al, had de-veloped due to many factors which increase intracranial pressure. They protruded into the sinus lumen in such a way that it could cause stenosis or obstruction of the sinus.

In conclusion it can be said that an obstructive lesion of dural sinus is considered of itself to be DAVM in most cases and sinus thrombosis is the result of the DAVM.