前脊髄動脈症候群を呈した脊髄動静脈奇形の２例 発症機序との関係について

• Material Type: 記事
• Title: 前脊髄動脈症候群を呈した脊髄動静脈奇形の２例 発症機序との関係について
• Author Heading: 村田 顕也; 高柳 哲也; 岩崎 聖; 島田 啓司; 辻村 総太
• Publication Date: 1996
• Publication Date (W3CDTF): 1996
• Alternative Title: 発症機序との関係について
• Periodical title: 脳卒中
• No. or year of volume/issue: 18 5
• Volume: 18
• Issue: 5
• Pages: 403-408
• Publication date of volume/issue (W3CDTF): 1996
• ISSN (Periodical Title): 09120726
• ISSN-L (Periodical Title): 09120726
• Publication (Periodical Title): The Japan Stroke Society
• Text Language Code: ja
• Subject Heading: anterior spinal artery syndrome; spinal arteriovenous malformations; MRI; spinal angiography
• Target Audience: 一般
• DOI: 10.3995/jstroke.18.403; https://doi.org/10.3995/jstroke.18.403
• Related Material (URI): https://search.jamas.or.jp/link/ui/1997157536
• Data Provider (Database): 国立情報学研究所 : CiNii Research; https://cir.nii.ac.jp/
• Original Data Provider (Database): Japan Link Center; https://japanlinkcenter.org/top; Crossref; https://www.crossref.org; CiNii Articles
• NAID: 130003438979; 10005235858

• Summary, etc.: We report two cases of spinal arteriovenous malformations presenting with anterior spinal artery syndrome. Case 1 was a 40-year-old woman. She was admitted to this hospital because of numbness in the bilateral lower extremities and severe lumbago, which were suddenly manifested on exertion. Case 2 was a 19-year-old man. He was transmitted to this hospital because of precordial oppression and complete motor paraplegia, which were manifested suddenly at rest. In both cases, spinal palsy, dissociated sensory disturbance, and bowel and bladder dysfunctions were observed clinically, and MRI of the spinal cord demonstrated findings suggestive of spinal ischemia and/or infarction in the anterior region of the spinal cord. On the basis of these findings, we diagnosed the two cases as anterior spinal artery syndrome. Conservative treatments were not effective, and both patients developed sensory disturbances. MRI of the spinal cord was performed a second time, and it demonstrated tortuous vascular lesions at the dorsal site of the spinal cord by the flow void phenomenon. Spinal angiography revealed arteriovenous malformations (dural type in case 1, and intradural type in case 2). We consider both cases to be intersting not only with respect to the pathoetiology of anterior spinal artery syndrome caused by spinal arteriovenous malformations, but also with respect to the results of various neuraradiologic examinations, such as MRI of the spinal cord and spinal angiography.; 前脊髄動脈症候群を呈した脊髄動静脈奇形の2例を報告した.症例1は, 40歳, 女性.労作時突然発症した両側下肢しびれ感, 腰背部激痛を主訴に来院した.症例2は, 19歳, 男性.安静時突然発症した前胸部絞扼感, 両側下肢運動麻痺を主訴に入院となった.いずれの症例も臨床的には, 脊髄麻痺, 解離性感覚障害, 膀胱直腸障害を呈し, 脊髄MRI検査では, 脊髄前方に虚血, 梗塞を示唆する所見を認めた.前脊髄動脈症候群と診断し, 治療を施行したが, 臨床症状は軽快せず, 感覚障害を中心に増悪を示した.この為, 再度胸髄MRIを施行したところ, 脊髄背側にflow-voidを呈した蛇行血管陰影を認めた.脊髄血管撮影では, 症例1は, 硬膜型, 症例2は, 硬膜内型の脊髄動静脈奇形と診断できた.本症例は, 脊髄動静脈奇形や前脊髄動脈症候群の発症機序, 確定及び鑑別診断そしてMRIや脊髄血管撮影を始めとする各種神経放射線検査の重要性を認識する上で興味深い症例と考えられた.
• DOI: 10.3995/jstroke.18.403
• Access Restrictions: インターネット公開
• Data Provider (Database): 科学技術振興機構 : J-STAGE; http://www.jstage.jst.go.jp