経動脈的および経静脈的塞栓術が有効であった下錐体静脈洞部硬膜動静脈瘻の1例

A Case of Dural Arteriovenous Fistula of the Inferior Petrosal Sinus Successfully Treated by Transarterial and Transvenous Embolizations

Ⅰ．はじめに

　硬膜動静脈瘻は硬膜壁内に異常な動静脈吻合を生じることにより，多彩な症状を呈する疾患で主に後天的要因が考えられている^3）．本症は通常海綿静脈洞部に好発し，下錐体静脈洞部に発生することは稀である．今回われわれは眼症状で発症した稀な下錐体静脈洞部の硬膜動静脈瘻に対し，経動脈的および経静脈的に塞栓術を行うことで，症状を完治することができた1例を経験したので，若干の文献的考察を加え報告する．

A 69-year-old male was admitted with chemosis and exophthalmos of his right eye. Angiograms revealed a dural ar-teriovenous fistula (AVF) involving the right inferior petrosal sinus. The AVF was fed by the right occipital and as-cending pharyngeal arteries and drained into the cavernous sinus and right superior ophthalmic vein from the right inferior petrosal sinus. He was treated by transarterial embolization with polyvinyl alchohol in order to reduce the shunt-flow through the fistula. Then he was treated by transvenous embolization with GDC coils five days after the arterial embolization.