Kayama T, Suzuki S, Sakurai Y, Nagayama T, Ogawa A, Yoshimoto T
Neurosurgery. 1986 Apr;18(4):465-8. doi: 10.1227/00006123-198604000-00014.
It is well known that moyamoya disease sometimes is accompanied by cerebral aneurysm; however, no case of moyamoya disease with arteriovenous malformation has previously been published. We report such a case. A 33-year-old man suffered from transient left motor weakness and visual disturbance. Plain computed tomography (CT) showed a low density area in the left parietooccipital cortex. Enhanced CT revealed a ribbon-shaped enhanced area in the right temporooccipital cortex and a spotty enhanced area in the right frontal subcortex. Cerebral angiography revealed moyamoya disease. On the basis of Suzuki's angiographic classification, the patient was diagnosed as Stage III. Right carotid angiography revealed an arteriovenous malformation fed by basal moyamoya vessels and draining to the vein of Trolard and the sylvian vein of the right frontal lobe. This arteriovenous malformation consisted of feeders, the nidus, and drainers. Trolard's vein, which was one of the draining veins of the arteriovenous malformation, flowed to the moyamoya vessels of the right parietal vault.
众所周知，烟雾病有时会伴有脑动脉瘤；然而，此前尚未有烟雾病合并动静脉畸形的病例报道。我们报告这样一例病例。一名33岁男性出现短暂性左侧肢体运动无力和视觉障碍。头颅平扫计算机断层扫描（CT）显示左侧顶枕叶皮质有低密度区。增强CT显示右侧颞枕叶皮质有条带状强化区，右侧额叶皮质下有斑点状强化区。脑血管造影显示为烟雾病。根据铃木血管造影分类，该患者被诊断为Ⅲ期。右侧颈动脉造影显示一个由基底烟雾病血管供血并引流至Trolard静脉和右侧额叶外侧裂静脉的动静脉畸形。这个动静脉畸形由供血动脉、畸形团和引流静脉组成。Trolard静脉作为动静脉畸形的引流静脉之一，流向右侧顶叶穹窿部的烟雾病血管。
