脊髄動静脈奇形 : その臨床症状および診断について

概要

論文の詳細を見る
Clinical courses, neurological findings and radiological features have been analyzed on five surgically verified cases of arterio-venous malformations (AVM) of the spinal cord. Among the five cases, two took a progressive course, another 2 took an intermittent course, and one took apoplectic course. There are two main mechanisms which cause spinal cord damage by AVM. One is hemorrhage from AVM and the other is "blood steal" by AVM. In our cases, history of episodes suggested subarachnoid hemorrhage in 3 cases. Besides the 2 cases which showed a progressive course, of which cause assumed to be the "steal phenomenon", 2 cases had a history of worsening of cord signs following the drinking of alcohol or the taking warm bathes. One other case had a history of so called "intermittent claudication". Therefore, blood steal by AVM may either give steady and constant damage or intermittent damage to the spinal cord. Clinical neurological signs do not always exactly correspond to the entire lesions. In two cases, the lesions extended several segments above the upper most level of the neurological signs. Lumbar puncture revealed elevated total protein in 4 cases without spinal block which is characteristic of this disease. As for radiological findings, in 2 cases we failed to demonstrate entire lesions by spinal angiogram. Therefore, it is mandatory to perform myodil myelogram on all cases before surgery.
北里大学の論文
1975-12-31