著明な症候を呈した中脳・脳幹部出血の2症例—Weber症候群とOne and a half症候群

Two Cases of Well-Known Syndrome due to Midbrain・Brain Stem Hemorrhage : Weber's Syndrome and One and a Half Syndrome

　高血圧歴のない患者に発症した中脳・脳幹部出血により，著明な症候群を呈した2例について報告した。症例1は62歳女性で，中脳出血によるWeber症候群を呈し，脳血管撮影にてモヤモヤ病と診断された。保存的治療にて左片麻痺は徐々に改善されたが，右動眼神経麻痺はほとんど改善されなかった。症例2は24歳男性で，脳幹部出血によるOne and a half症候群を呈し，脳血管撮影およびMRI所見から海綿状血管腫によるものと診断された。減圧目的に緊急に血腫吸引除去術を行い，直後より神経症状の著明な改善が得られた。Weber症候群およびOne and a half症候群について，若干の文献的考察を加えた。

Two cases of well-known syndrome due to mid-brain-brain stem hemorrhage without having a history of hypertension were reported. Case 1 is a 62-year-old female, presenting Weber's syndrome due to midbrain hemorrhage and diagnosed as Moyamoya disease angiographically. Case 2 is a 24 -year-old-male, presenting One and a half syn-drome due to brain stem hemorrhage from a brain stem cavernous angioma, which was diagnosed angiographically and by magnetic resonance imag-ing (MRI) . Left hemiparesis seen in case 1 had improved by conservative therapy but no improve-ment could be obtained in the oculomotor nerve palsy. In case 2, hematoma was aspirated surgically for the purpose of decompression and his neuro-logical symptoms improved markedly. Their path-ogenesis and pathophysiology were also discussed.