分裂病様状態を呈した脳底部異常血管網の1例

A CASE OF SCHIZOPHRENIC STATE COMBINED WITH INTRACRANIAL RETE MIRABILE VASCULARITY

はじめに

　内頸動脈の狭窄および脳底部の異常血管網を呈し，種種の神経症状を呈する疾患群が，すでに，多数報告されている^{2）4）7）10）}。しかし，精神症状を主徴とした症例の報告は少ない^{5）8）12）}。われわれは遺伝負因を有し，結婚をきつかけとして精神症状が顕現化し，精神分裂病の疑いという診断で入院，脳血管写によつて内頸動脈サイフォン部狭窄と脳底部に異常網状血管像が認められた症例を経験した。心因反応ないし精神分裂病の診断について考えさせられたので，ここに報告する。

The patient, twenty one years old, female admit-ted to the Hospital of Kumamoto University because of her headache on the thirteenth January 1968. Since two years prior to admission she had com-plained of headache and lack of interests in her en-vironment, and she had been idea of reference, spended the whole day in bed and not got on with her work. She revealed the schizophrenic symptoms, such as volitional weakness, blunting of feeling, indifference and inactivity, but she was different from schizophrenia at the point preserving contact with environment. Neurological examination noted slight left hemiparesis. Laboratory data disclosed no specific abnormalities. The electroencephalogram showed irregular 9-10c/s a activity in resting re-cord, sporadic the waves on all area and paroxysmal delta waves localized in both frontal regions, es-pecially by hyperventilation. However, recovering the clinical symptomes, slow waves decreased grad-ually.

The pneumoencephalogram showed slight dilata-tion of the right lateral ventricle. The carotid an-giographies showed slight bilateral narrowing of the cervical portion of the internal carotid artery and bilateral occlusion of the carotid siphon, and cerebral arteries peripherad to the siphon could not be found. Abnormal fein vascular network so-called rete mirabile were found bilateraly at the base of thebrain.

The vertebral angiography showed normal run-ning of posterior cerebral artery and retrograde filling of branches supplying the frontal and parietal protions through the posterior pericallosal artery.

Some cases of a group showing specific intra-cranial vascular abnormality have been reported in Japan. However, the present case with psycho-logical symptoms was rare and quite different from those of intracranial rete mirabile vascularity.