Basilar Artery Vasculitis Secondary to Sphenoid Sinusitis : Case Report
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概要
- 論文の詳細を見る
A 35-year-old male presented with basilar artery vasculitis secondary to sphenoid sinusitis manifesting as rapidly deteriorating symptoms including consciousness disturbance and right hemiparesis. Computed tomography (CT) on admission showed sphenoid sinusitis without intracranial lesion. Emergency angiography demonstrated basilar artery stenosis. The neurological deterioration was considered to be caused by ischemia of the perforating arteries branching from the stenotic portion of the basilar artery. The patient was treated with urokinase infusion through a microcatheter just proximal to the stenosis 3 hours after the onset of the symptoms. His consciousness level and right hemiparesis markedly improved immediately after the procedure. Magnetic resonance (MR) imaging on day 5 revealed that extension of the sphenoid sinusitis into the prepontine cistern had formed an abscess which was attached to the clivus. The basilar artery was embedded in the abscess at the angiographic stenosis. Cerebrospinal fluid (CSF) analysis showed white blood cell count of 601/mm^3 with 82% neutrophils, 89.2 mg/dl protein, and 31 mg/dl glucose. No causative organism in the CSF could be identified by smear or culture. Early MR imaging and CSF examination are recommended when patients present with both ischemic symptoms involving the basilar artery and opacification of the sphenoid sinus on CT to identify basilar artery vasculitis secondary to sphenoid sinusitis.
- 日本脳神経外科学会の論文
- 2001-09-15
著者
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SORIMACHI Takatoshi
Department of Neurosurgery, Nishiogi-chuo Hospital
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TAKEUCHI Shigekazu
Department of Neurosurgery,Brain Research Institute,Niigata University
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Takeuchi Shigekazu
Department Of Neurosurgery Brain Research Institute Niigata University
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Kamada Kenichi
Department Of Neurosurgery Sannocho Hospital
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OZAWA Tsunenori
Department of Neurosurgery, Brain Research Institute, Niigata University
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Ozawa Tsunenori
Department Of Neurosurgery Brain Research Institute Niigata University
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Sorimachi Takatoshi
Department Of Neurological Surgery Niigata Rosai Hospital:m.d. Department Of Neurosurgery Brain Rese
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