頸胸部脊髄蔓状血管腫の症例

THE CASE REPORT OF RACEMOSE HAEMANGIOMA OF THE CERVICOTHORACIC SPINAL CORD

I．はじめに

　脊髄血管系の異常によつて脊髄腫瘍類似の臨床像を現わす一群の疾患がある。これらの疾患の臨床的報告は1887年Gaupp^4）の脊髄軟膜静脈瘤をもつて嚆矢とし，1929年Globus^5）はこれらの腫瘍，非腫瘍のものをあわせて，1）　Venous dilatation, 2）　Arterial or arteriovenous　aneurysms, 3）　Haemangioma　（a：　intramedullary, b：　extramedullary　（pial），　c：　extradural　（epidural），　d：　vertebral）に分類した。

　これらすべてを含めても一次性脊髄血管異常は比較的まれな疾患とされている。私は最近硬膜内髄外蔓状血管腫の1例を経験したので報告する。

The case report of 18 year old male with racemose hemangioma of the cervicothoracic spinal cord is presented.

The onset was the one of subarachnoidal haemor-rhage which disappeared for a while, however, recur-red the symptom again 5 months later.

A-P X-ray revealed the enlargement of T₁, T₂ vertebral canal. The myelogram showed the picture of likewise map or swirl in shape at the level of C₆ down to T₁ vertebrae and shadow defect like ascaris in shape located on the level of C₇ down to T₁ vertebra, from the uppermid to left lateral down-ward. The shadow of bilaterai root-porch are conspicuous, and partial saddle shaped shadow located on the level of T₁ T₂ pedicle.

The laminectomy of C₅ down to T₂ was performed which revealed the haemangioma, dark purple in colour spreading over the operation field of C₅ to T₂ upper and downward. Furthermore, cicatric tissue, bean in size, was found at the back of spinal cord on the level of T₁-T₂ pedicle. Dural plastic was performed.

Paralysis is unchanged 4 months later postoperatively.

So-called haemangioma of the spinal cord, mostly comprehending haemangioma, varix, aneurysm and so forth as to the abnormality of the blood vessels of the spinal cord, is not so rare as we have expected and may take this for the subarachnoical haemorrhage and spinal apoplexy.

Preoperative diagnosis is mostly difficult to set up, however, acute progress and intermittent paralysis are the characteristic. X-ray reveals the enlargement of the vertebral canal, the myelogram shows characteristic shadow of likewise map and ascaris in shape.

The treatment for this, total extirpation is desirable, and if not, the laminectomy and resection of Lig. denticulatum are of great help for the release of involved spinal cord.