頭蓋内結核腫

INTRACRANIAL TUBERCULOMA

I．緒言

　頭蓋内結核腫の報告は，1790年にFord^24）が報告してから現在まで，枚挙のいとまがない。1889年および1893年に，Starrは，成人では，脳腫瘍300例中41例に，19歳以下では，300例中152例もの高率に，結核腫の存在を示した。その後，公衆衛生の進歩とともに，結核そのものが減少し，1928年Van Wagenenは1.4％という低率に頭蓋内結核腫が減少していることを報告した。さらに抗結核剤の進歩によつて，頭蓋内結核腫は，今日では，はなはだめずらしいものとなつている。東大脳神経を示す。

Recently, the occurrence of intracranial tuberculomas has markedly diminished. Since 1933, 22 cases of int-racranial tuberculomas were encountered in this dep-artment. This comprised 0.9% of intracranial space-occupying lesions experienced in our department. The disease was mostly seen in young patients under the age of 30 years; however, in case of males, as shown in the diagram, the peak of occurrence was also high under the age of 10 years. The frequency of occurrence was almost the same in males and females in our cases. As for the localization, it was found to be 11 cases in the cerebral hemispheres, 8 cases in the cerebellar hemispheres, 2 cases in the vermis and 1 case in the upper brain stem. There-fore, the majority of cases were found in the cerebral and cerebellar hemispheres. All the tuberculomas were solitary. Clacification of tuberculoma was found in 2 cases. Complications of meningitis occured in 5 cases out of which 4 cases expired. In the total of 22 cas-es, 8 cases had a history of tuberculosis. Two cases died postoperatively and 3 cases died of meningitis without operative intervention. Satisfactory postope-rative results were seen in 17 cases. In 11 cases whe-re surgical treatment was done in conjunction with the administration of anti-tuberculous drugs, the mor-tality rate was found to be 0. It is of our opinion basing on the above cases, the treatment of choice would be a combination of operative treatment and administration of anti-tuberculous therapy.