小児水頭症の脳血管写上の特長

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タイトル別名
  • ショウニ スイトウショウ ノ ノウ ケッカン シャジョウ ノ トクチョウ
  • Angiographical Findings in Infantile Hydrocephalus
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36例の6歳以下の小児水頭症について,脳血管写上の特長を検討した。1.動脈像の造影は十分であっても,静脈像は正常小児と異なり,造影が不十分であった。2.側面像でTuberculum sellaeとBregmaを結んだ線の中点と,脳梁動脈がこれを横切る点を偏位量とすると,この偏位は気脳写による側脳室前角極の脳実質の厚みと相関し,脳室の拡大に伴う脳梁動脈の挙上を認めた。3.中大脳動脈主幹の走行のJimenez and Goreeの参考線からの偏位は,一例を除き正常範囲にあり,脳室拡大による変動は有意ではなかった。また側脳室前角極の脳実質の厚みとも有意の相関を認めなかった。4.静脈角は交通性水頭症の症例においても後下方への移動を示した。5.脳底動脈頂部と基準線(鞍結節と内後頭結節を結ぶ線)のなす平均角度は,交通性水頭症では28.0°で,中脳水道狭窄症では14.7°であり,脳室拡大と脳底動脈頂部の位置は,中脳水道狭窄症については相関関係を認めた。6.後大脳動脈はすべて下方偏位し,交通性水頭症では,P_2とP_4間に相関関係を認めた。

The angiograms were studied in 36 cases of hydrocephalic infants and children up to the age of 6 yearsold. 1) The arterial phase of the cerebral angiogram was more consistent, easier to assess and generally more reliable than the venous phase, because venous filling was not so complete as in normal infants. 2) The distance from the position, at which the pericallosal artery crosses the line between the tuberculum sellae and the endobregma, to the midpoint of its line was measured. These measurements were compared with the width of the cerebral mantle at the anterior pole of the frontal lobe measured by pneumoencephalography, and a good correlation was found between these variants. 3) No correlation was found between the position of the middle cerebral artery axis and the width of the cerebral mantle. 4) The angle between the line from the tuberculum sellae to the inion and that from the tuberculum sellae to the tip of the basilar artery was 28.0° in communicating hydrocephalus, while 14.7° in aqueduct stenosis. It was found in aqueduct stenosis that the thinner the cerebral mantle, the smaller the angle. 5) A correlation was found between the width of circular segment (P_2) and that of quadrigeminal portion (P_4) of the posterior cerebral artery, in communicating hydrocephalus. 6) The position of venous angle could be displaced backward and downward even in the cases of communicating hydrocephalus.

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