外傷性椎骨動脈解離に伴う脳底動脈閉塞症に対して急性期血管内治療が有効であった1例

A Case of Basilar Artery Occlusion of Traumatic Vertebral Artery Dissection Successfully Managed by Endovascular Treatment

Ⅰ．はじめに

　外傷性椎骨動脈閉塞は，頸椎骨折の合併症の1つであり，ひとたび発症し，さらに脳底動脈閉塞も合併した場合，重篤な後遺症を残し予後は不良である．外傷性椎骨動脈解離に脳底動脈閉塞を合併した場合，極めて緊急な治療を要する．

　今回われわれは，頸椎骨折に伴う外傷性椎骨動脈解離による椎骨動脈閉塞および脳底動脈閉塞合併例に対し，急性期血栓溶解と椎骨動脈ステント留置を施行し有効であった1例を経験したので報告する．

The author describes a case of basilar artery occlusion caused by vertebral artery dissection with vertebral frac-ture. A 61-year-old man was admitted with neck pain after a traffic accident. His symptoms suddenly deteriorated and cerebral angiography revealed an occlusion of the right vertebral artery, and complete occlusion of the basilar ar-tery. Local-arterial fibrinolysis with urokinase for basilar artery occlusion and angioplasty with the use of a self-ex-pandable stent for the site of the vertebral artery dissection was performed, and the basilar artery was partialy recanalized.