手術により局所脳血流量の改善を認めた前頭蓋窩硬膜動静脈瘻の1例

The Improvement in Regional Cerebral Blood Flow in the Anterior Cranial Fossa which was Affected by a Dural Arteriovenous Fistula:Case Report

Ⅰ．はじめに

　前頭蓋窩硬膜動静脈瘻は，出血発症が80％を占める^9）．われわれは非出血性の前頭蓋窩硬膜動静脈瘻について，その特徴について報告した^7）．今回，頭痛で発症した非血性の前頭蓋窩硬膜動静脈瘻で，術前に¹²³Ⅰ—iodoamphetamine single photonemission computed tomography（¹²³Ⅰ—IMP SPECT）で左後頭葉を中心に局所脳血流量（rCBF）の低下がみられ術後に改善した症例を経験した．症例を提示し，文献的考察を加え報告する．

We report a case of dural arteriovenous fistula of the anterior cranial fossa with venous ischemia.

A 55-year-old man presented with headache and visual disturbance. Neurological examination showed no abnormal-ity. MR images demonstrated flow void at the right anterior cranial fossa.Right internal carotid angiograms showed a dural arteriovenous fistula of the anterior cranial fossa, fed by the anterior ethmoidal artery. The draining vein was the leptomeningeal vein draining into the basal vein, the straight sinus, and the left transverse sinus.