Myelopathyで発症した特発性内頸動脈海綿静脈洞瘻の1例

Cavernous Arteriovenous Fistula Presenting Myelopathy : A Case Report

Ⅰ．はじめに

　Myelopathyの原因としては脊椎・脊髄腫瘍や変性疾患が多く，頭蓋内に生じた硬膜動静脈瘻（dural arteriovenous fistula：DAVF）がmyelopathyを示すことは稀で^9），海綿静脈洞部硬膜動静脈瘻が脊髄症状を示した例はわれわれが調べ得た範囲では1例^14）を認めるのみである．今回われわれは，myelopathyで発症した特発性内頸動脈海綿静脈洞瘻の1例を経験したので，若干の文献的考察を加えて報告する．

Intracranial dural arteriovenous fistula (DAVF) rarely presents with myelopathy. We discuss the diagnosis and treatment of this entity. A 76-year-old woman presented with tetraparesis and sphincter dysfunction. Magnetic reso-nance imaging demonstrated a high signal intensity from the medulla oblongata to the upper cervical cord on T2-weighted images. Angiograms showed a cavernous DAVF and venous drainage to perimedullary spinal veins via the petrosal vein. It was concluded that, myelopathy had resulted from congestion of the spinal veins.