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Title: 拡散テンソル画像が病態理解に有用であった両側性小脳性運動性失調で発症した中脳正中部梗塞の1例
Other Titles: A case of midbrain infarction with acute bilateral cerebellar ataxia visualized by diffusion tensor imaging
Authors: 真屋, 由佳1 Browse this author
川堀, 真人2 Browse this author →KAKEN DB
大浦, 大輔3 Browse this author
新谷, 好正4 Browse this author
岩崎, 素之5 Browse this author
馬渕, 正二6 Browse this author
Authors(alt): Maya, Yuka1
Kawabori, Masahito2
Oura, Daisuke3
Niiya, Yoshimasa4
Iwasaki, Motoyuki5
Mabuchi, Shoji6
Keywords: 両側性小脳性運動失調
bilateral cerebral ataxia
midbrain infarction
diffusion tensor imaging
decussation of superior cerebellar peduncle
Issue Date: Aug-2016
Publisher: 日本神経学会
Journal Title: 臨床神経学
Journal Title(alt): Rinsho Shinkeigaku
Volume: 56
Issue: 8
Start Page: 565
End Page: 568
Publisher DOI: 10.5692/
Abstract: 症例は85歳女性。歩行時のふらつきとろれつがまわらないことを主訴に来院した。来院時、比較的重度の両側性の小脳性運動失調と運動失調性構音障害を認め、画像検査にて中脳正中部に限局した急性期梗塞巣を認めた。両側小脳半球には異常を認めなかった。中脳正中部に限局した梗塞巣で両側小脳失調の原因として、小脳赤核路の交叉部位である上小脳脚交叉での障害による症状が考えられた。拡散テンソル画像(Diffusion tensor imaging;DTI)において、左右の小脳核から投射される線維が交叉する上小脳脚交叉部位と今回の病巣が一致する画像が得られ、神経症状の病態理解に有効であったと考えられた。
An 85-year-old woman with hypertension was admitted with a sudden onset of gait disturbance and dysarthria. On admission, the patient showed severe bilateral cerebellar ataxia with moderate right medial longitudinal fasciculus (MLF) syndrome. Magnetic resonance (MR) imaging showed an acute infarction in the lower and medial part of midbrain. Diffusion tensor imaging (DTI) started from both cerebellar peduncles revealed that the lesion of the acute infarction matched the decussation of superior cerebellar peduncle where crossing of tract was seen and a part of its tract was interrupted at the site. Interruption of the cerebellum red nuclear path at the medial part of midbrain was considered to be the reason for bilateral cerebellar ataxia and visualization of cerebellum red nuclear path by DTI can give better understanding of the neurological symptom.
Type: article (author version)
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 川堀 真人

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