同側大脳半球萎縮をきたした脳腫瘍

TWO CASES OF THALAMIC TUMOR WITH IPSILATERAL CEREBRAL HEMIATROPHY

緒言

　最近，われわれは慢性に進行する片麻痺を示す患者に対して精密検査の目的にて頸動脈写および気脳写などを施行したところ，片麻痺の対側において大脳半球萎縮が認められ，これを詳細に観察し，あるいは試験穿刺によって生検したところ，萎縮側の視床部に脳腫瘍が発見された興味ある2症例を経験したので報告する。この一側大脳半球萎縮と脳腫瘍との因果関係についても私見を述べるが御批判を頂ければ幸いである。

In the paper, two cases of thalamic tumor with ipsilateral cerebral hemiatrophy were reported, and the cause of these hemiatrophy was discussed.

Case 1 : Patient was 17 years old boy. At the age of eleven, he got the right hemiparesis which was aggravated slowly. With carotid angiogram and pneumoencephalogram, the cerebral hemiatro-phy of left side was revealed which was taken one year and three months after the onset. The tumor in the temporo-occipito-thalamic region was extir-pated subtotally at one year and nine months after the oneset.

After the surgery, he had received the therapy of the irradiation of 6000 γ of Co⁶⁰. He is now going into the occupational training. He has now a satisfactory time even 4 years after that surgery. Case 2 : Patient was 14 years old school boy. He was suffered from the light hemiparesis which was aggravated slowly just like the previous case. The cerebral hemiatrophy of right side was shown with carotid angiogram and pneumoencephalogram which were taken one year and six months after the onset.

And the pneumoroulette tomogram revealed tumor shadow at the right thalamic region. He developed the abnormal behavior and dementia at the two years and six months after the onset. And the cerebral hemiatrophy could not find by x-ray examination at that time.

By stereotaxic exploratory puncture, this tumor was revealed as pinealoma. He was irradiated with 6000 γ of Co⁶⁰. The correlation with the thalamic tumor and the ipsilateral cerebral hemiatrophy was discussed.

In the thalamic tumor with chronic course it is suggested that the thalamic ganglion cells might be degenerated by the invation of tumor. As the result, the afferent and efferent nerve fibers might be degenerated following the cerebral hemiatrophy at the tumor side. The authors would like to emphasize that pneumoroulette tomography was most useful for the diagnosis of thalamic tumor in early stage.