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Brain and Nerve No to Shinkei Volume 41, Issue 4 （April 1989）

Brain and Nerve 脳と神経 41巻4号（1989年4月発行）

Japanese English

原著

脳腫瘍の局所脳血流量に及ぼす遠位効果について—SPECTによる検討 THE REMOTE EFFECTS OF BRAIN TUMORS ON CEREBRAL BLOOD FLOW AS MEASURED BY SINGLE PHOTON EMISSION CT 荒木有三 ¹ , 今尾幸則 ¹ , 坂井昇 ¹ , 清水言行 ¹ , 平田俊文 ¹ , 山田弘 ¹ Yuzo Araki ¹ , Yukinori Imao ¹ , Noboru Sakai ¹ , Kotoyuki Shimizu ¹ , Toshihumi Hirata ¹ , Hiromu Yamada ¹ ¹岐阜大学医学部脳神経外科 ¹Department of Neurosurgery, University of Gifu School of Medicine pp.367-374

発行日 1989年4月1日 Published Date 1989/4/1

DOI https://doi.org/10.11477/mf.1406206294

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Abstract 文献概要
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　抄録　脳腫瘍と関連して見られる遠位部位の局所脳血流量の低下（remote effect）について，テント上脳腫瘍44例を対象として，¹³³Xe吸入法または¹²³I-IMP静注法SPECTによって検討を行った。一側大脳半球に腫瘍の限局する症例35例中，対側小脳半球血流量の低下（contralateral cerebellar hypoperfusion-CCH）は18例51％に認められた。CCHは前頭頭頂部の腫瘍で，特に病変が内包や放線冠に波及した場合に高率に出現した。病巣の大きさと小脳半球血流量は負の相関を示した。また，血流値を対照群と比較すると対側のみならず同側小脳半球血流量も有意に低下を示した。しかし，対側大脳半球における病巣と対称部位の局所脳血流量は統計的に有意な低下を示さなかった。閉塞性水頭症例では，術前，両側性に小脳半球血流量の有意な低下を認めたが，術後は正常化した。従来，脳梗塞などの脳血管障害例で多く報告されているremote effectは脳腫瘍例でも比較的高率に発現し，その機序としては経神経的な抑制の関与が最も強く想定された。

In order to assess the remote effects of supra-tentorial brain tumors, the cerebellar blood flow and cerebral blood flow of the symmetrical re-gions in the contralateral cerebral hemispspheres were measured by single photon emission CT. Forty four patients with supratentorial brain tu-mors, such as gliomas, meningiomas and germ cell tumors etc., were included in this study.

Contralateral cerebellar hypoperfusion (CCH) was exihibited in 51%, 18 of 35 unilateral brain tumors. Regarding tumor location, CCH was more correlated with frontoparietal lesions.

The mean values of contralateral ΔCerebellar blood flows (ΔCBFs) were lower than those of ipsilateral ΔCeBFs, and also statistically, bilateral tICeBFs significantly decreased. The greater the volume of lesions including peritumoral edemas,the lower the ΔCeBF became. Among the 9 cases with obstructive hydrocephalus, the preoperative ΔCeBFs which had decreased significantly, return-ed to normal postoperatively.

Statistically, it seemed that there was no trans-callosal supression caused by unilateral brain tu-mors. However the ΔrCBF of the mirror foci in postoperative patients decreased significantly. In conclusion, the remote effects on the cereb-ral blood flow, which are common in strokes cases, were demonstrated in many cases of supratento-rial brain tumors and the occurrence of CCH was closely related to the frontoparietal lesion in-cluding the tumor and peritumoral edema. Also the mechanism of CCH was discussed with preference for a transneural supression.