脊髄動脈症候群:疼痛優位の病像
Liam Robert Smith1, Lay Kun Kho1, Ferry Dharsono2
1Royal Perth Hospital, East Metropolitan Health Service, Perth, Western Australia, 6000, Australia.
BJR case reports
|January 20, 2026
まとめ
アーブ麻痺の既往がある男性が、脊髄梗塞による重度の腕痛を経験した。画像検査では脊髄の変化と椎骨動脈の閉塞が明らかになり、梗塞のメカニズムについての考察を促した。
科学分野:
- 神経学
- 血管神経学
- 脊髄画像診断
背景:
- アーブ麻痺は新生児期の腕神経叢損傷であり、長期的な神経学的影響を及ぼす可能性がある。
- 脊髄梗塞は、血管障害と関連することが多い稀で重篤な病態である。
- 根性痛は、様々な脊髄病変の提示症状となりうる。
研究 の 目的:
- アーブ麻痺の既往がある成人における脊髄梗塞の症例を提示する。
- 脊髄梗塞の臨床像と潜在的なメカニズムについて議論する。
- 本症例における感覚運動障害の欠如の理由を仮説する。
主な方法:
- 41歳男性患者の症例報告。
- 臨床神経学的検査。
- 脳および脊髄のMRI検査。
- 椎骨動脈評価のための血管造影。
主要な成果:
- 患者は重度の両側性、掻爬性の根性腕痛を呈した。
- 神経学的検査では異常は認められなかった。
- MRIでは右脊髄のT2高信号が示された。
- 血管造影では左椎骨動脈(V4部)の閉塞が示された。
結論:
- 脊髄梗塞は血管異常の文脈で発生し、非定型的に提示される可能性がある。
- 本症例は、先天性疾患の既往がある場合でも、脊髄病変の血管原因を考慮することの重要性を強調する。
- 脊髄梗塞の証拠があるにもかかわらず感覚運動障害がない理由を説明する仮説が提案される。
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