小脳延髄槽に寄生せる嚢虫症の1手術例

AN OPERATIVE CASE WITH CYSTICERCOSIS WHICH WAS FOUND IN CISTERNA CEREBELLOMEDULLARIS

I．緒言

　脳に寄生する嚢虫症は，わが国において福島^6），が明治41年に報告してから50例近くにおよぶが，手術症例は10例にみたない。われわれの教室においては，かつて鈴木ら^7）が1手術治験例を報告しているが，最近小脳延髄槽に寄生し天幕下腫瘍を疑わせた症例に手術を行ない，嚢虫を除去し軽快せしめたので報告する。

On the Cysticercosis in the brain, about 50 cases were found in literatures since the first case was re-ported by Fukushima in 1907, but only about 10 cases were treated by surgical operation.

Recently we had an operative case of 22 year old female with Cysticercosis which was found in Cisterna cerebellomedullaris.

Her first symptome occured at the age of 11 year old with headache, and at 16 year old nausea and vomitting were added. About 3 monthes before her adomitting to our surgical clinic, convulsion with right temporal headache was observed.

The fundoscopy demonstrated bilateral papilla edema. The blood examination showed evident eosinophily (8,5%). Pneumoventriclogram demonstrated symmet-rical hydrocephallus internus.

An operation was performed for the questionable subtentorial tumor or inflamatery blocking of Foramen Magendii and Lschka. After the suboccipital cranio-tomy was made, various cysticercus (up to the size of the thumb-tip) were found in Cisterna cerebellomedul-laris and also on the pons and medulla oblongata. They contacted by a tip of themaelves on their wall without compression to the nervous and vascural sys-tems. Total 18 of cysticercus were removed completely. We could not find them in the 4th ventricle.

The histological diagnosis was the Cysticercosis due to Taenia solium.

As the clouding of consciousness and visual distur-bance caused by intracranical hypertension was observed on the 4th postoperative day, the V-A shunt operation was performed.

Her symptomes disappeared except the visual ditur-bance postoperatively.