頭蓋内視神経膠腫の診断と治療

DIAGNOSIS AND TREATMENT OF GLIOMA OF THE INTRACRANIAL PORTION OF THE OPTIC NERVE AND CHIASM

I．はじめに

　頭蓋内に発生する視神経膠腫は，これによつて発現してくる神経症状，脳下垂体機能におよぼす影響，その特異な組織所見，そしてまたvon Recklinghausen氏病との関連性など，きわめて興味のある疾患であるが，欧米における文献にもその報告は比較的少なく，本邦においてはきわめて稀^12）にその報告をみるのみである。

　われわれは手術所見ならびに組織学的所見によつて確診した頭蓋内視神経膠腫を11年前に1例，最近の3年半に4例経験したので，これらの症例についての臨床症状レ線所見ならびに組織学的所見とその治療について検討を加えてみた。

Primary glioma of the intracranial portion of the optic nerve and the chiasm are slowly glowing benign type of intracranial neopiasm. Early diagnosis and proper surgical treatment always promises a good prognosis. However, in an early stage, the diagnosis of this condition is not an easy one. When the extent of the neoplasm is limited to the intracranial Portion, the presenting symptoms are limited to dis-turbance of vision on one side and sometimes to pituitary disfunction. Radiological examinations are not much of help in such cases. Cerebral angio-graphy may show slight upward displacement of the proximal portion of the anterior cerebral artery which similar to that of other suprasellar tumors. Air study may show thickened optic nerves in lucky cases. In most of the cases, however, it is almost impossible to obtain definitive diagnosis by radio-logical studies.

Surgical exploration by way of the frontal cranio-tomy is the only way to establish definitive diagnosis and we feel surgical removal of the tumor is the only proper treatment for this lesion.