正常圧水頭症に対するshunt手術の効果指標としてのクレペリン精神作業検査

KRAEPELIN'S CALCULATING TEST AS AN INDICATOR OF SHUNT-OPERATION EFFECT FOR NORMAL PRESSURE HYDROCEPHALUS (NPH)

I．はじめに

　正常圧水頭症（normal pressure hydrocephalus）（以下，NPHと記す）は，1965年Adamsらによつてその概念が提唱されて以来多1の報告がみられる。しかし，なお幾多の問題点も残つており，その主なるものの1つは手術適応，すなわち術前に手術効果を予知し得る問題であり，他の1つは，術後の効果を客観的にとらえる手段であろうと思われる。

　箸者は，NPHに対して脳室腹膜腔吻合術（以下，V—P shuntと記す。）を行なつた症例の中10例について，術前から術後に亘つてクレペリン精神作業検査を行なつた。この方法は，手術効果を客観的に表示する手段として適当な検査法と考えられるので，ここに報告し諸賢の御批判を仰ぐ次第である。

Many reports have been issued since the first report on NPH by Adams et al. in 1965, and shunting operation is reported as the most efficient procedure for this condition. However, still some problems are remained to be solved, for example we have no generally accepted objective evaluating method for mental activity of NPH-patient in pre-and post-shuntoperation.

The author chose Kraepelin's calculating test, which is continuing adding of at random series of one figure numbers and result rate of every minute and correct or erroneous rates are used as the indicator for mental capacity according Yokota's standard. The reproducibility and stability of this test are realized again on the cases of this report.

The most essential appreciation for the treatmentof NPH is mental activity itself and not size of the ventricle nor improving of EEG.

This report has proved that the Kraepelin's calculating test with Yokota's standard is stable objective indicator for mental activity of NPH-patient, and pre-and post-shuntoperation evaluation was mentioned.