一側脳室拡大の臨床的観察

A CLINCAL STUDY OF UNILATERAL VENTRICULAR ENLARGEMENT

緒言

　1918年Dandy^2）が空気による脳室の撮影に成功して以来，空気脳室撮影法は頭蓋内疾患の最も有力な方法の1つとして現在まで広く行なわれてきた。更に技術的な改良が加えられ，その適応範囲はますます広まりつつあり，頭蓋内疾患は勿論，多くの疾患に関する気脳写像の報告は枚挙にいとまがない。

　空気脳室撮影の主な目的は，脳室の大きさ，偏位，変形，蜘蛛膜下腔の状態を知ることにあるが，疾患によってその所見は様々であり，日常我々が経験するこれらの症例の中には明らかに一側のみの脳室の拡大を示すものがある。頭部外傷においてはTroland^l8）等によると29％に，石井^8）によると50例中11例に一側脳室拡大をみている。脳血管障害の気脳写像にも一側脳室拡大の症例は多くみられているが，これらの報告のほとんどは疾患別にまとめたものであり，一側脳室拡大の側から論じたものはHunter等^7）の他にあまり文献をみない。

A clinical study of 40 patients with unilateral ventricular enlargements were performed. The measurements of ventricles were performed with Engeset's method. Thirty-five patients were male and 5 female. Those ages ranged from 5 to 71 years with a peak incidence in the age group 41-50. The incidences of the etiological factor were head injury, vascular disease, infection and in some cases were unknown. Chief clinical features were head-ache, motor paralysis of extremities, nausea, vomiting and mental disoder. But clinical features did not correlate with the severity of the ventri-cular enlargement. It may be taken careful that, sometimes, it showed symptomes resembling with brain tumor. In the excess cases, 29 of 40 cases, the enlargement occured on the left side ; the dom-inant hemispheres were affected. The septum pel-lucidum was more frequently displaced toward the smaller ventricle. Of the 40 patients, general uni-lateral enlargement was in 23, focal in 15 and general with additional focal enlargement in 2. The elec-troencephalogram (EEG) examined from 32 patients, and normal EEGs were obtained in only 9 patients, abnormal EEGs in 13 patients and borderline EEGs in 10 patients. The follow-up results showed that 10 of 20 patients had improved, 8 were symptoma-tically unchanged, 5 had deteriorated but no patient had died.