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Ⅰ.はじめに
硬膜動静脈瘻(dural arteriovenous fistula:dAVF)は,静脈洞壁に存在する硬膜血管の動静脈シャントと考えられているが,その病因,病態,予後については未だ不明な点が多い.一般的には耳鳴りや拍動性頭痛などの症状で発症し,緩徐な経過をたどる予後良好の疾患であると考えられているが,脳内出血,くも膜下出血,静脈性梗塞等による急性発症で重篤な症状を呈する例も存在する.今回われわれは自験例について検討し,出血を来しやすいdAVFについて文献的考察を交えて報告する.
The majority of dural arteriovenous fistulas are considered to have a benign clinical course, but some behave more aggressively, causing progressive neurological symptoms and/or intracranial hemorrhage. Several classifications of an-giographic findings have been reported to predict what findings might result in catastrophic presentation. Cortical ve-nous drainage has been described as one of the major risk factors of hemorrhage. We reviewed the records of 50 patients with dural arteriovenous fistulas admitted to our institution from 1991 to 2001 and analyzed their venous drainage patterns with reference to Cognard's classification.
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