男性に発症した特発性脳偽腫瘍の1例

Idiopathic pseudotumor cerebri in a male

　特発性脳偽腫瘍は本邦では比較的稀な疾患であり，また肥満の中年女性に多いとされている。筆者らは軽度肥満の男性に発症した症例を経験した。症例は51歳男性で，左眼の霧視を主訴に受診。視力は右1.2，左0.8。両眼視神経は慢性うっ血乳頭の所見を示し，視野にはマリオット盲点の拡大がみられた。CT, MRIにて異常所見はなく，脳脊髄液圧は初圧430mmH₂Oと充進していたが性状に異常はなかった。また眼球運動，全身的な神経学的異常をみなかった。これらの臨床的特徴により特発性脳偽腫瘍と診断し，炭酸脱水酵素阻害剤内服，シャント術を施行，現在経過観察中である。

A 51-year-old slightly obese male presented with blurring of vision in the left eye. His visual acuity was 1.2 right and 0.8 left. Chronic papilledema with enlarged blind spot was present in both eyes. No abnormal findings were seen by computed tomography and magnetic resonance imaging of the brain. There was increase of pressure at 430 mmH₂O but no change in components of cerebrospinal fluid. There was no abnormality in ocular motility nor systemic neurological features. The patient was diagnosed as idiopathic pseudotumor cerebri. Systemic acetazolamide followed by shunting surgery for the cerebrospinal fluid resulted in improvement in ocular findings. This case is reported because of its infrequency in the Japanese and particularly in males.