後大脳動脈解離—症例報告および文献学的考察

Isolated Posterior Cerebral Artery Dissection—Case Report and Review of the Literature

Ⅰ．はじめに

　若年脳卒中の原因として脳動脈解離は重要であり，とりわけ本邦においては欧米とは異なり椎骨脳底動脈系が多いのが特徴である．その中でも後大脳動脈領域の解離は比較的稀ではあるが，MR画像の進歩により近年散見されるようになった^8，11,12）．今回われわれは，虚血にて発症した右後大脳動脈（PCA）の解離性病変の症例を経験したので，渉猟し得た28症例と合わせて文献的考察を加えながら本疾患の特徴，病因，診断，治療の現状等について考察する．

Although dissecting aneurysms appear not to be as rare as previously reported, their etiology remains unclear. We describe a rare case of a girl with ischemia in the region of the posterior cerebral artery (PCA). The patient com-plained of a mild headache and left upper paresthesia. Neurological findings revealed a mild left hemiparesis. Visual field was intact, and cardiac embolism was excluded due to the almost normal chest X-p, ECG, and UCG. Laboratory findings were within normal limits. However, MRA and angiography revealed a linear shadow and an irregular caliber change at the right P1-P2 segment.