多彩な神経心理学的症状を呈した脳梁膨大部astrocytomaの1例

A Case of Splenial Astrocytoma with Various Neuropsychological Symptoms

　化学療法および放射線療法により腫瘍陰影が消失した後，多彩な神経心理学的症状を呈した脳梁膨大部astrocytomaの1例を報告した。40歳の右利きのトラック運転手が記憶障害および運転中に道に迷うという困難のため脳神経外科を受診し，脳梁膨大部のprotoplasmic astrocytomaの診断のもとに化学療法および放射線照射が行われた。十分な治療効果が得られた後，顕著な記憶障害と性格変化のため，前記治療の約1年8カ月後に神経精神科に入院となった。脱抑制傾向，破廉恥行動などの性格変化のほか，①半球間離断症状（左視野の読みの障害）②記憶障害および③視知覚障害が認められた。記憶障害は失見当識を伴い，前向健忘（記銘減弱）および逆向健忘よりなり，ほぼ定型的な健忘症候群に相当し，いわゆる膨大後部健忘（retros—plenial amnesia）であると考えられた。視知覚障害は従来記載されている種々の視知覚検査における顕著な成績低下よりなる。

A case with splenial astrocytoma that showed various neuropsychological symptoms after disappearence of tumor due to chemo- and radia-tion therapies. A 40-year-old right-handed truck driver visited the Neurosurgical Clinic with com-plaints of memory disturbance and loosing his way during truck driving. Under diagnosis of protoplas-mic astrocytoma chemotherapy and radiation treat-ments were carried out. These treatments were satisfactorily effective, but the patient showed marked memory deficits and personality change. He was hospitalized, therefore, into the Neuropsychi-atric Clinic 20 months after the above mentioned treatments. Aside personality changes such as lack of inhibition and shameless acts, the patient showed interhemispheric disconnection symptoms (dyslexia in the left visual hemifield), memory deficits, and visual perceptual disturbances. His memory deficits consisted of anterograde and retrograde amnesias and disorientation of time and place, indicating that he had typical amnesic syndrome. In other words he had so-called retrosplenial amnesia. His visual perceptual deficits were impaired performance on many tasks already described as tests of visual perception.