脳葉・深部(混合型)脳卒中と多発性微小出血を認めた脳小血管病—脳小血管病による多彩な臨床症状と脳画像所見の検討：1症例報告

Cereberal Small Vessel Disease with a Combination of Lobar and Deep(Mixed)Stroke and Multiple Cerebral Microbleeds, the Examination of the Varied Clinical Symtoms and the Brain Imaging Findings due to Cerebral Small Vessel Disease: a Case Report

抄録　今回，脳小血管病(cerebral small vessel disease：CSVD)による多彩な臨床症状を呈した60代男性症例を報告した。本例は繰り返す脳卒中と頻回なてんかん発作を呈し，次第に認知・運動機能障害や精神症状が顕著となった。近年CSVDの特徴的所見の1つである脳微小出血(cerebral microbleed：MB)は，一定数の出現と認知機能障害，脳卒中などの臨床症状との関連が指摘されている。本例は当初より多数のMBを認め，その後のMB拡大・増大と連動する形で脳卒中やてんかん発作を繰り返し血管性認知症に至った。MBはCSVDの症状・経過の把握・予見につながる重要なバイオマーカーと思われる。

　We reported a case of a male in his 60s who exhibited various clinical symptoms due to cerebral small vessel disease(CSDV). The patient suffered from repeated strokes and frequent epileptic seizures, and garadually showed cognitive and motor dysfunction, as well as psychiatric symptoms. In recent years, there has been a corelation with the number of crebral microbleed(MB) which is one of the characteristic of CSVD, and clinical symptoms such as cognitive dysfunction and stroke. In this case, multiple MBs were not only observed from the begining, but also strokes and epileptic sezures were repeated in line with the subsequent changes in size and number of MB, leading to vascular dementia. MB might be an important biomarker that leads to the grasping and the prediction of clnical sympoms and course in CSVD.