脊髄内Hemangioblastomaの全摘

HEMANGIOBLASTOMA OF THE SPINAL CORD:REPORT OF A CASE OF SUCCESFUL REMOVAL

はじめに

　脊髄の血管奇形^{1）7）11）15）16）}，あるいは髄内腫瘍^3）4）6）の摘出手術は，最近の脳神経外科における進歩の1つである。脊髄のHemangioblastomaは，多くの場合，髄内にあり，同時に脊髄背面に血管奇形様の，逆行する太い血管を伴つているので，摘出手術は，困難なものと考えられてきた疾患である^10）。これは，脊髄腫瘍の中でも稀なもので，Sloop等^8）の1,322例の脊髄腫瘍のうち，4例，Guidetti等^6）の255例中5例となつている。又，後頭蓋窩のHemangioblastomaと共存，あるいは，Lindau病の分症として存在する例が多い^{8）9）17）}。我々は，最近，Lindau病の家系の一人に発生した，脊髄内Hemangio—blastomaの全摘出を行ない良い結果を得たので，それを報告し，文献的考察を加えたい。

A case of intramedullary hemangioblastoma of thoracic region was decrived. The patient was 20 year-old female and belonged to a family of hered-itary "Lindau's disease". Four years ago, she re-ceived a treatment because of retinal hemangioma of left eye and hemangioblastoma of area postrema.

In this time, she showed signs and symptoms of transection of the spinal cord at the level of Th9 and myelogram revealed intramedullary tumor and serpiginous defect. At operation, tortous varices and intramedullary tumor (hemanglioblastoma) were total removed under operating microscope. She showed rapid improvement and could walk without support 3 months after operation.

The authors reviewed and discussed about hem-angioblastoma of the spinal cord, especially about its diagnosis, operative procedure and usefulness of microsurgical tecniques in spinal cord surgery.