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[两例伴有脑室内出血的烟雾病成人病例——脑室周围血管解剖的血管造影评估]

[Two adult cases of moyamoya disease with intraventricular hemorrhage--angiographic evaluation of periventricular vascular anatomy].

作者信息

Utsunomiya H, Hayashi T, Shogima K, Sato Y, Maehara F, Okudera T

出版信息

No Shinkei Geka. 1986 Aug;14(9):1105-10.

PMID:3774099
Abstract

In order to show the vascular anatomy in periventricular region, two adult cases of moyamoya disease with intracerebral hemorrhage extending into lateral ventricle were presented. And we discussed the relation between the vascular anatomy and the form of hemorrhage in moyamoya disease. The first case was a 46-year-old woman admitted for nausea and vomiting following headache for four days. CT scan revealed a high density area in the upper portion of body of right lateral ventricle showing intracerebral hemorrhage which extended into the lateral ventricle. On angiogram, typical moyamoya disease was noted. The ventriculofugal arteries from the posterior lateral choroidal artery was detected which indicated developed ventriculofugal perfusion. The second case was a 52-year-old man who was hospitalized sudden onset of headache, vomiting and consciousness disturbance. CT scan revealed a high density area suggesting of hemorrhage in the head of right caudate nucleus. It perforated into the right anterior horn of lateral ventricle with spreading over the other ventricles. We observed similar findings on the angiograms to the first case. In this case, however, the lateral striate arteries were involved instead of the posterior lateral choroidal artery. It should be pointed out that, in both cases, the area of hemorrhage in CT scan coincided with the area of developed ventriculofugal perfusion in angiograms.

摘要

为了显示脑室周围区域的血管解剖结构,我们展示了2例患有脑出血且血肿延伸至侧脑室的成年烟雾病病例。并且我们讨论了烟雾病中血管解剖结构与出血形式之间的关系。第一例是一名46岁女性,因头痛4天后出现恶心呕吐入院。CT扫描显示右侧侧脑室体部上部有高密度区,提示脑出血并延伸至侧脑室。血管造影显示为典型的烟雾病。检测到来自脉络膜后外侧动脉的脑室离心动脉,提示脑室离心灌注发育良好。第二例是一名52岁男性,因突发头痛、呕吐和意识障碍入院。CT扫描显示右侧尾状核头部有高密度区,提示出血。血肿穿破进入右侧侧脑室前角并蔓延至其他脑室。我们在血管造影上观察到与第一例相似的表现。然而,在该病例中,受累的是外侧纹状体动脉而非脉络膜后外侧动脉。应该指出的是,在这两个病例中,CT扫描上的出血区域与血管造影上脑室离心灌注发育良好的区域相吻合。

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