側脳室髄膜腫—その1例と統計的考察

THE MENINGIOMA WITHIN THE LATERAL VENTRICLE:A CASE REPORT AND THE ANALYSIS OF 64 CASES FROM REFERENCES

はじめに

　側脳室に発生する髄膜腫は稀なものであり，一般に臨床症状は特有な局所所見を示さず，単に脳圧亢進症状のみのことや，後頭葉，ときに小脳の病変を疑わさせるような症状を示すこともある。他方本腫瘍は早期に手術を行なえばその予後は極めて良好であるので，特に早期診断が重要である。

　私共は最近，側脳室髄膜腫の1例を経験し，これを全摘治癒させたのでその臨床所見を述べるとともに，1954年以降の欧文文献から私共の調査し得た64例について，特に本腫瘍の臨床症状，理学的検査所見，診断，治療，予後等について報告する。

Although the meningioma within the lateral ventricle is rare and involvement of one occurs in 1-4% of meningiomas, it is interesting of clinical aspects.

A case of the meningioma within the right ven-tricle on a 51-year-old male which was succesfully removed was presented.

His chief complaints of ataxia and light headache began in January of 1970. On his admission in May, clinical features were the left homonimous hemianopsia, the papilloedema on the both sides, the right hemiparesis and ataxia.

An operation was performed throgh the right parieto-occipital craniotomy, revealed a solid tumor 64g in weight, lying in the trigone of the right posterior horn.

A histological diagnosis confirmed a fibroblastic meningioma.

In addition to this case report, authors presented the analysis of clinical aspects about 64 cases of the lateral-ventricle-meningoma picked up from references since 1954. The summary of the re-ferences is as follows ; 1) Numbers of the cases are little more in females than in males.

2) The origine of a tumor is recognized more in the left ventricle than in the right one.

3) Symptomes and clinical signs consisted of continuous or intermittent headache from a few months to a few years, visual field defect, weakness of extremities, hemiparesis, sensory nerve distur-bance, ataxia and so on.

4) A plain X-ray film shows the calcification of the tumor in 14.1%.

5) The pneumogramm sometimes might show the outline of a part of the tumor in the ventricle.

6) In the arteriogramm, it should be noticed the elongation and enlargement of the anterior and posterior choroidal artery.

7) On the brain scanning, a large accumulation of 99m-Tc sodium pertechnetata with a clear out-line is appeared in the center of the skull.

8) It seems ideal to be performed a total removal, if possible, which would promise to a get a smooth course and improvement except the hemianopsia.