腎動脈狭窄による続発性アルドステロン症に認められた脳血管写所見について

CEREBRAL ANGIOGRAPHICAL FINDINGS OF THE SECONDARY ALDOSTERONISM DUE TO RENAL ARTERIAL STENOSIS

I．はじめに

　腎動脈狭窄による高血圧症ないし続発性アルドステロン症は，以前考えられていたより多いと最近はいわれている^7）8）。しかし，まだ，その脳血管写像についての報告はない。

　当切，急性脳圧亢進症状のために脳腫瘍を疑われ，入院後，腎動脈狭窄による続発性アルドステロン症と診断された症例の腎摘出術前後に施行した脳血管写について報告する。

(1) We have reported a case, 7-year-old boy, of secondary aldosteronism due to renal arterial stenosis and his cerebral angiograms.

(2) Comparing the angiograms between acute stage and reconvulscent stage (7 months later after nephrectomy), we could make sure the angiographical features of hypertensive encephalopathy due to sec-ondary aldosteronism.

These are as follows :

1) In the extracranial portion, both external and internal carotids show marked narrowings.

2) In the intracranial portion, we could not find any signs of caliber change, the some of them showed rather dilatation more than the diameter of normal. stage. Generaly speaking, they showed diffuse segmental constriction.

3) Cerebral circulation time showed,

i) arterial phases prolonged twice as that of reconvulscent stage

ii) relative earlier filling of the deep veins than veins

(3) This is probably the first report about cerebral angiograms of secondary aldosteronism.