診断困難なりしグリオブラストーマ・ムルチホルメ特に放射性P32による髄液代謝其の他の検討

A Case of Frontal Glioblastoma Multiform its Diagnosis was very difficult. (Radioactive P32 Investigation on the-Blood Brain and Blood-Liquor Barrier)

序言

　Dandyによる脳室造影術の創始，Bailey-Cu-shing等先達による脳外科の黎明によつて脳腫瘍の局在診断は次第に確実性を増し，腫瘍摘出も抗菌性物質の発明，麻酔法の発達，脳室ドレナーヂの採用^1）等により成績は向上しつゝあるが，尚間間診断困難，或は誤診例を散見し，経験している現状である。我々は最近入院前一回の全身痙攣をもち両側視力減退を主訴として入院したが，神経学的には両側欝血乳頭，腹壁反射の消失を示すだけで脳室像及び脳波所見に著明な変化なく，死後剖見によつて始めて左前頭部の多形性膠芽細胞腫であつた事が判明した症例を経験したので，その臨床経過について述べ反省すると共に，放射性P³²による髄液代謝及び剖見せる中枢神経各部位の含水量とその放射能分布について述べる。

A Case of 32 aged man with frontal glio-blastoma multiform was reported. His chief neurological signs were severe increased intra-cranial pressure and acute developed severe choked disc. And other marked signs, abnor-mal discharge on EEG and pathological fin-dings in ventriculoscopy could not be found, besides pneumoventriculography was almost normal,

Therefore, though we diagnosed him as bra-in tumor, we could not clear up its localiza-tion, and we were surprized, finding it was right frontal glioblastoma multiform by ne-cropsy, The blood-liquor barrier by radioa-ctive F³² was investigated, as the result, we knew the permeability of F³² to cerebrospinal fluid from blood was very high and this was suppressed very much by injection of 50% glucose.

Distribution of radioactive F³² in brain tis-sue obtained by necropsy was researched, as the result, we knew radioactivity in tumor and its neighborhood was higher than the other place of brain tissue.

The amount of contained water in brain ti-ssue was measured, the contained water in homolateral cerebral hemisphele to the tumor was more than it in contralateral one.