濱口 浩敏

Hirotoshi HAMAGUCHI

北播磨総合医療センター脳神経内科

Department of Neurology, Kita-Harima Medical Center

キーワード : carotid artery, rare disease, ultrasound images

日常臨床の現場では，様々な血管疾患に遭遇する．頭頸部領域においては，名称は知っていても実際に遭遇する機会が少ない疾患と，非常に稀な疾患の両者が存在する．前者の代表が血管炎であり，後者については走行異常や動脈瘤などが代表的である．血管炎においては，大型血管炎である高安動脈炎，巨細胞性動脈炎を知っておく必要がある．また，もやもや病など病態の主座が頭蓋内動脈に存在する場合において，頸部動脈に影響がでることで特徴的な病態を認めることもある．さらに，椎骨動脈解離やBow hunter症候群など椎骨動脈領域にも比較的稀な病態が存在する．また，非常に稀な疾患として，内頸動脈無形成，Carotidynia，頸動脈仮性動脈瘤などが挙げられる．これら稀な疾患に遭遇したときには動画を駆使して明瞭な画像を残すことを心がけてもらいたい．

A variety of vascular diseases are encountered in the clinical setting in Japan. Vascular diseases of the head and neck include both those that are infrequently encountered even if their names are familiar and those that are extremely rare. A typical example of the former is vasculitis, and an anatomical anomaly is a typical example of the latter. Forms of vasculitis one should be aware of are Takayasu's arteritis and giant cell arteritis, which are types of large-vessel vasculitis. In the case of pathophysiologies that involve mainly the intracranial arteries, such as moyamoya disease, distinctive findings may be observed when the cervical arteries are affected. In addition, there are relatively rare pathophysiologies in the area of the vertebral arteries, such as vertebral artery dissection and bow hunter's syndrome. Rarer diseases include internal carotid artery aplasia, carotidynia, and false aneurysm of the carotid artery. When these rare diseases are encountered, steps should be taken to ensure that video is utilized to obtain clear images.