髄膜脳嚢瘤切除後に発生した一側内水頭症の1治験例

Unilateral Hydrocephalus due to Inflammatory Occlusion of Foramen of Monro:Report of a Successful Case

I．はじめに

　モンロー氏孔閉塞による一側内水頭症は，腫瘍性病変特に脳室内腫瘍によつて起こる場合が多く，非腫瘍性病変によつて起こることはまれとされている。最近，われわれは鼻根部髄膜脳嚢瘤切除後の感染を起因として発生した一側内水頭症の1例を経験したので報告する。

A successfully operated case of unilateral hydro-cephalus resulting from inflammatory obstruction of the foramen of Monro was reported. The occlusion seemed to be due to infection of the lateral ventricle following the removal of meningo-encephalocysto-cele complicated by a liquor fistula at the root of the nose.

The patient, underwent an operation for meningo-encephalocystocele accompanying a liquor fistula at the root of the nose 31 clays after birth. Pneumoven-triculography just before the operation revealed marked dilatation and deformity of the left lateral ventricle and slight dilatation of the right ventricle. However, the communication between the both ven-tricles was comfirmed by the air study. Cerebro-spinal fluid was contaminated by the Pseudomonas aeruginosa, and ventricle drainage of 5 days duration was needed. The patient discharged 15 days after operation without any neurological abnormality.

He was readmitted on Jun. 8, 1968, complaining of nausea, vomiting, anorexia and headache. At admission the left half of the skull was larger than the right, and neurological examination revealed slight weakness of right upper extremity and bilat-eral papilledema. Pneumoventriculography by punc-ture of the left anterior horn demonstrated the extremely dilated left lateral ventricle, but no air in the right ventricle.

Craniotomy was performed on Jun. 24, 1968. The inner surface of the left lateral ventricle was gen-erally smooth. The choroid plexus and the foramen of Monro were not identified. An opening of 1. 5 cm in diameter was made in the septum pellucidum. Histologically the specimen from the septum was proved to be glial scar. The patient discharged on Sep. 16. 1968, in good health.