ステント留置術後に興味ある脳循環の変動を示し，痴呆症状が改善した両側内頸動脈狭窄症の1例

Bilateral Carotid Stenting for Bilateral Carotid Artery Stenosis Improved Vascular Dementia

Ⅰ．はじめに

　Misery perfusionを示す脳主幹動脈閉塞性疾患は，高率に脳卒中発作を起こすことが知られている^14,16）．しかし，高齢者では認知機能や活気が経年的に低下するため^2），神経症状の進行は見逃されやすく，その治療時期を逸することも稀ではない．今回，両側頸部内頸動脈狭窄による進行性痴呆に対して，両側ステント留置術を行い痴呆症状の改善が得られた症例を経験したので報告する．

We report a case of bilateral internal carotid artery (ICA) stenosis treated with stenting. A 78-year-old man suf-fered from vascular dementia and left hemiparesis, and, by magnetic resonance angiogram (MRA), was diagnosed as having bilateral ICA stenosis. Cerebral angiogram showed severe, bilateral ICA stenosis (right; 88%, left; 93%) and xenon single photon emission tomography (SPECT) showed severely decreased cerebral blood flow (CBF) and cere-brovascular reactivity (CVR). We performed bilateral carotid angioplasty with self-expanding stents. Both CBF and CVR were improved bilaterally after the operation.