中大脳動脈狭窄によるlimb-shakingを伴う一過性脳虚血発作に対して経皮的血管形成術が奏効した1例

A Case of Middle Cerebral Artery Stenosis Presented with Limb-Shaking TIA

Limb-shakingを伴う一過性脳虚血発作（以下，limb-shaking TIA）は内頸動脈閉塞あるいは狭窄に伴う稀な臨床症候として報告されている。われわれは71歳，女性で，中大脳動脈狭窄によるlimb-shaking TIAをきたし，中大脳動脈狭窄に対する経皮的血管形成術（PTA）にて症状が消失した1例を経験した。以後，TIAの再発，中大脳動脈狭窄の再狭窄は認めていない。Limb-shaking TIAは中大脳動脈狭窄の一症状となりうると考えられ，PTAは有効な治療法と考えられた。

Abstract

Involuntary movement is a rare clinical manifestation of transient ischemic attack (TIA). However, limb-shaking TIA is well described presentation of carotid occlusive disease. We present the case of a patient who developed limb-shaking TIA associated with high-grade stenosis of middle cerebral artery (M1), which was treated with percutaneous transluminal angioplasty (PTA). The procedure was performed successfully without complication and the symptom disappeared immediately after the procedure. The patient remained free of symptoms at the 38-month follow-up. There was no tendency of restenosis of M1. In this case, PTA was technically feasible and beneficial for limb-shaking TIA with M1 stenosis. Limb-shaking TIA can be a symptom of high-grade stenosis of M1.

(Received December 14, 2015; Accepted December 21, 2015; Published July 1, 2016)