1 0 0 0 OA 小脳梗塞により失語を呈したcerebellar cognitive affective syndrome(CCAS)をMRIによるarterial spin label(ASL)法にて確認し得た1例
- 著者
- 白坂 智英 伊藤 康裕 丸一 勝彦 小林 浩之 寺坂 俊介
- 出版者
- 公益社団法人 日本リハビリテーション医学会
- 雑誌
- The Japanese Journal of Rehabilitation Medicine (ISSN:18813526)
- 巻号頁・発行日
- vol.59, no.4, pp.432-438, 2022-04-18 (Released:2022-06-27)
- 参考文献数
- 17
Higher brain dysfunctions commonly interfere with functional reconstruction during rehabilitation. Most culprit lesions causing higher brain dysfunctions are observed in the cerebral cortex. However, recently, higher brain dysfunction caused by cerebellar lesions, termed cerebellar cognitive affective syndrome (CCAS), has attracted attention. Here, we report a case of CCAS in a patient with cerebellar infarction exhibiting aphasia, where arterial spin labeling (ASL) method of magnetic resonance imaging (MRI) was used to confirm decreased blood flow due to crossed cerebello-cerebral diaschisis (CCCD). The patient was a 5x years old, left-handed female. She was initially admitted to a neurosurgical hospital for dizziness. MRI demonstrated cerebellar infarction in the left posterior inferior cerebellar artery area. The next day, she was admitted to our hospital for surgery after the diagnosis of hemorrhagic cerebellar infarction due to progressive loss of consciousness. Craniotomy was performed to remove the hematoma. Neurological examination revealed fluent aphasia and ataxia in the left upper and lower extremities and trunk. ASL demonstrated decreased cerebral blood flow in the left cerebellar hemisphere and right front-temporal lobe. Therefore, we detected that CCCD resulted in higher brain dysfunction. After 3 months of inpatient rehabilitation, the patient's auditory comprehension, word conversion, and word recall improved. The patient was discharged unaided. This study used ASL to confirm the diagnosis and rehabilitation of the CCAS incidence effectively.
1 0 0 0 OA 脳MRIによる非侵襲的導電率イメージングの開発
電流の流れやすさを示す指標である導電率は、体内臓器や組織系によって値が異なる。導電率を非侵襲的に測定できれば異なる組織の区別が可能となり、病的状態での組織系の予測診断の補助が期待できる。本研究は、脳MRIによる非侵襲的導電率イメージングを開発し、この方法による頭蓋内構造の導電率測定の正確性を明らかにすることを目的とした。脳MRIによる非侵襲的導電率測定法の正確性、非侵襲的導電率測定の有用性等について検討した。脳MRIによる非侵襲的導電率測定の再現性の高さ、電極を用いての組織の導電率測定結果との一致率の良さ、神経芽腫をより悪性度の低い神経膠腫から区別できること、等が示された。