急性中心性頸髄損傷症候群（Schneidr）について

ON THE SYNDROME OF ACUTE CENTRAL CERVICAL SPINAL CORD INJURY

I．緒論

　頸椎は身体のかなりの重量部分を有する頭蓋，脳を支持するとともに頸髄を収容してこれを保護しまた脊柱ではその運動性はもつとも大きくたえず運動をしいられている。しかも頸椎部位では脊髄は脊椎管内壁ともつとも密接した状態にある。したがつてなんらかの機転で頭部，顔面に打撃を受け頸部が急激に後屈（または前屈）し頸髄自身は集約的に力学的作用を受けやすくひいては障害を惹起する—Hyperextension injury—。そのさいSchneiderら^18）19）（'54，'58）は明らかな頸椎骨打，脱臼の有無と関係なく頸髄の一定範囲に可逆性，浮腫性変化から出血（Haematomye—lia）または完全破壊にいたる種々の段階の病変が生ずることを認めこれに基づく一定症候群の発来につき急性中心性頸髄損傷症候群（The synd—rome of acute central cervical spinal cord injury）と命名した。われわれは最近浮腫型にみられる典型的な症候群の発生と回復を示した2例を経験したので若干の考察とともにここに報告する。

We have recently experienced two cases with so-called, the syndrome of acute central spinal cord injury which had been reported by Schneider (1954 and 1958).

These cases showed the typical course of edematous type regarding quadriplegia and disturbances of the urinary bladder, and rev-ealed, on the other hand, marked finding of plexus root lesion (numbness and radiating pain in both shoulders, upper extremities and chest) rather than the spinal cord lesion on sensory disturbances. Any of these cases was cured by the cervical traction or other proce-dures. From our experiences, it seems to me that contused wound and rentogenological findings of the intervertebral foramina of the cervical body may be significantly helpful to make the diagnosis of this syndrome.

The mechanism of this syndrome has been stated to be related to cervical hyperextent-ion, (hyperextention injury of the cervicalsp-inal cord) due to head injury and the main factors of pathogenic cause could be ascribed to regressive process of the cervical body and broad ligamentum. Recent study has, how-ever, suggested that another factor such as circulatory disturbances should be investiga-ted throughly.