精神症状が前面に出た両側前大脳動脈及び右中大脳動脈閉塞症の1例

A CASE OF OCCLUSION OF BILATERAL ANTERIOR AND RIGHT MIDDLE CEREBRAL ARTERIES MANIFESTED BY PSYCHOTIC SYMPTOMS

はじめに

　前大脳動脈閉塞症の報告は比較的少なく^1）〜4），精神障害の詳しい記載も乏しい^2）。感情，意識，知能などの精神機能の脳局在に関しては今日なお未解明のことが多く，前大脳動脈閉塞症の1例1例を可能な限り正確に記載し，閉塞部位との関連を解明してゆくことは意義のあることと考える。

　最近われわれは，精神症状を初発ならびに主症状とする両側前大脳動脈閉塞症の1例を経験したので，若干の文献的考察を加え報告する。

A 36-year-old man with bilateral anterior and right middle cerebral artery occlusion manifested by psychotic symptoms was reported.

The patient showed abnormal behaviors and developed the left hemiparesis about a month before admission.

As to the psychotic symptoms, emotional dis-turbance, disorientation to time and loss of insight into disease were noted.

The neurological examination revealed anisocoria (rt.>lt.), the left hemiparesis dominant in the lower limb, agraphia, acalculia and constructional apraxia. The carotid angiograms revealed occlusion of the arteries at the right A₁, the right M₁ and the left A₃ portion.

Correlation between psychotic symptoms and cerebral artery occlusion was discussed.