視力低下と視野障害で発見された閉塞性水頭症を伴う松果体囊胞の1例

A case of pineal cyst and obstructive hydrocephalus with impaired vision and visual field defect as the initial clinical manifestation

要約　目的：視力と視野障害で発見された松果体囊胞の症例の報告。症例：24歳女性が1か月前からの頭痛と5日前からの左眼視力と視野障害で受診した。所見：矯正視力は右0.8，左0.09で，両眼に不規則な耳側の視野沈下があった。頭部のCTとMRIで松果体囊胞と脳室拡大があり，松果体囊胞の中脳水道圧迫による閉塞性水頭症と診断した。脳室ドレナージの後，2週後に松果体囊胞開放術が行われた。視力と視野は正常化し，3年後の現在まで再発はない。結論：本症例は視力と視野障害を初発徴候とする松果体囊胞で，早期診断と早期治療が奏効した。

Abstract.　Purpose：To report a case of pineal cyst with impaired vision and visual field defect as the initial clinical manifestation. Case：A 24-year-old female presented with headache, impaired vision and visual field defect in the left eye of recent onset. Findings：Corrected visual acuity was 0.8 right and 0.09 left. Both eyes showed irregular visual field defect with paracentral scotoma. Computed tomography and magnetic resonance imaging（MRI）showed pineal cyst with enlarged ventricles, leading to the diagnosis of pineal cyst with obstructive hydrocephalus due to obstructed aquaduct. After ventricular drainage, partial resection of pineal cyst 2 weeks later was followed by normalization of vision and visual field. There has been no recurrence for 3 years until present. Conclusion：Early diagnosis and surgical intervention were effective in the present case of pineal cyst with impaired vision and visual field defect.