片眼性特発性頭蓋内圧亢進症の2例

Two cases of idiopathic intracranial hypertension with unilateral papilledema

要約　目的：片眼のみに乳頭浮腫が生じた特発性頭蓋内圧亢進症の2症例の報告。症例：52歳男性と59歳女性の片眼に乳頭腫脹が発見された。両症例の視力は，左右眼とも1.2であった。脳脊髄圧は，それぞれ430mmHgと350mmHgであった。MRIで，頭蓋内の異常はなかった。両症例とも，片眼性特発性頭蓋内圧亢進症と診断された。1例はアセタゾラミドの内服で自覚症状と乳頭腫脹が軽快した。他の1例は治療を望まず，初診から3年間，他覚所見に変化はなかった。結論：特発性頭蓋内圧亢進症に併発した片眼性乳頭浮腫は，1例では薬物治療で寛解し，1例では3年間不変であった。両症例とも，経過監査中の期間，僚眼に異常は生じなかった。

Abstract.　Purpose：To report 2 cases of idiopathic intracranial hypertension with unilateral papilledema. Cases and Findings：Unilateral papilledema was detected by chance in a 52-year-old male and 59-year-old female. Corrected visual acuity was 1.2 in either eye in both cases. Cerebrospinal pressure was 430 mmHg and 350 mmHg respectively. Magnetic resonance imaging（MRI）showed no space-occupying lesion in the cranial cavity. Both cases were diagnosed with idiopathic intracranial hypertension with unilateral papilledema. Peroral acetazolamide was followed by resolution of papilledema in one case. In the other case who refused medical treatment, there has been no change in objective findings in either eye for 3 years until present. Conclusion：These cases illustrate that papilledema related to intracranial hypertension may respond to medication or may remain unchanged for over years. The fellow eye in both cases remained free of pathological changes during the period of observation.