STA-MCA anastomosisにより失語症状の改善を認めた1例

抄録

A 45-year-old man was admitted to our department with complaints of headache and speech disturbances on February 19th, 1978. A neurological examination revealed slight confusion of consciousness, disorientation and aphasia of predominantly sensory type with misunderstanding and perseveration. CT scan taken on the day of admission showed slight dilatation of the lateral ventricles, but no abnormal high or low density area was found. Left carotid angiogram disclosed occlusion of the horizontal portion of the MCA at 23mm from the bifurcation. The colateral circulation from the ACA to the MCA was also confirmed on the late arterial phase. The EEG showed slight slow activities in the left temporocentral regions. The standard language test of aphasia (SLTA) performed 24 days after attack revealed severe disturbances of the writing of the Japanese syllabary and Chinese characters. At the same time CT scan disclosed high density areas of the left middle and inferior temporal gyri by the contrast enhancement.
STA-MCA anastomosis was performed 26 days after attack. Left carotid angiogram performed 4 days after the operation showed improvement of hemodynamic pattern through the STA and the MCA. SLTA 14 days after the operation revealed much improvement of the writing of the Japanese syllabary. SLTA 60 days after the operation showed also improvement of the writing of the Chinese characters. The patient was discharged at 6 months after attack with minimum speech disturbances.