雑誌文献を検索します。書籍を検索する際には「書籍検索」を選択してください。

Brain and Nerve No to Shinkei Volume 24, Issue 10 （October 1972）

Brain and Nerve 脳と神経 24巻10号（1972年10月発行）

Japanese English

症例報告

Progressive Subcortical Gliosis （Neumann）と思われる初老期痴呆の1剖検例 AN AUTOPSY CASE OF PROGRESSIVE SUBCORTICAL GLIOSIS 調輝男 ¹ , 志田堅四郎 ¹ , 福島武雄 ² , 長野光生 ³ Teruo Shirabe ¹ , Kenshiro Shida ¹ , Takeo Fukushima ² , Mitsuo Nagano ³ ¹九州大学脳神経病研究所神経内科 ²九州大学病理学第一講座 ³井口野間病院精神科 ¹Department of Neurology, Neurological Institute Kyushu University ²Department of Pathology, Kyushu University ³Noma Psychiatric Hospital pp.1341-1347

発行日 1972年10月1日 Published Date 1972/10/1

DOI https://doi.org/10.11477/mf.1406203207

PDF(8548KB)

有料閲覧

Abstract 文献概要
1ページ目 Look Inside

緒言

　初老期痴呆の代表的疾患の1つであるPick病は1892年Arnold Pick^18）が進行性非動脈硬化性の痴呆を臨床的に記載したことにはじまる。1911年Alzheimer^1）はこの疾患に特異な病理所見を見出した。1926年OnariとSpatz^17）はこれを1つの疾患単位としてPick病と命名し，以後Pick病の報告があいついだ^{22）3）20）6）}。

　このPick病の特徴としては，特異な人格変化，特有な態度，滞渋言語などの臨床症状を呈し^{4）5）26）}，剖検で肉眼的に前頭葉あるいは側頭葉に限局性の萎縮がみられ，組織学的には層状の神経細胞脱落，Pick細胞とよばれる胞体の腫大した神経細胞および嗜銀球の出現，皮質下白質を中心とした膠質症が認められる^7）22），ということがあげられている。

A 63-year-old woman was admitted to the Noma Psychiatric Hospital, Fukuoka City, in September 1969, for progressive dementia. In December 1968, she had been noticed to become mentally dull. She could not manage the house work and wandered about anytime. At the time of admission, she was alert and unremarkable physically and neurologi-cally except for mild emaciation. Psychiatrically there were disorientation, memory impairment and character change. She was diagnosed as a presenile dementia. After admission, the dementia progress-ed and dirty behavior was seen. In September 1970, logoclonia was detected. Neurological examination at that time revealed rigospasticity in the neck and the extremities. She became bed-ridden there-after and died of bronchopneumonia on April 3, 1971.

At the time of autopsy, the brain weighed 930g. The leptomeninges were thickened and turbid slight-ly. There was mild atrophy in the frontal and temporal lobes on both sides. Moderate dilatation was apparent in the lateral and third ventricles.

With the light microscope, nerve cell loss, spongy change and gliosis in the gray matter were seen in the frontal and temporal lobes. The remaining nerve cells showed simple atrophy, swelling or va-cuolar degeneration. There were mild demyelina-tion and marked gliosis in the white matter in these lobes. Mild or moderate gliosis was seen also in the thalamus. basal ganglia, dentate nucleus, in-ferior olives and the anterior horns in the spinal cord. Senile plaques, neurofibrillary tangles and argyrophilic inclusions were not found in the cent-ral nervous system.

These neuropathological findings were different from those of Alzheimer's disease or Pick's disease and were thought to be akin to the "Progressive Subcortical Gliosis"" reported by Neumann et al. in 1967.