眼科で診断された頭蓋内腫瘍性疾患14例

Review of fourteen cases of intracranial tumor detected by ophthalmological examinations

　最近の約7年間に当眼科診療所で診断された頭蓋内腫瘍性疾患14例について検討した。頻度は調査期間中の初診患者数約43,000人の0.03％であった。疾患は下垂体腺腫7例，頭蓋咽頭腫1例，内頸動脈瘤1例，視交叉部髄膜腫1例と視交叉近傍の疾患が10例と多く，脳幹部聴神経腫，上咽頭癌，前頭葉髄膜腫がおのおの1例，詳細不明の脳腫1例であった。

　主訴は視力障害が多く，検査はゴールドマン動的量的視野検査が重要であった。特に内部イソプターの沈下の形や再現性のある視野欠損には注意を払う必要がある。副腎皮質ステロイド薬の投与により原因疾患の発見が遅れることがあり，また関連する他科領域の症状や受診歴についての問診も十分に行われなければならない。

We reviewed 14 cases of intracranial tumor detected by us during the foregoing 7 years. These cases comprises 0.03% of 43,000 patients seen during the same period. There were 10 cases of tumor located in the chiasmal region : pituitary adenoma 7 cases and one case each of craniopharyngeal tumor, aneurysm of internal carotid artery and meningeal tumor. The other 4 cases comprised one case each of acoustic neurinoma of the brain stem, nasopharyngioma, meningioma of the frontal lobe and brain tumor. Visual disturbance was the most frequent symptom in the present series. Perimetry with Goldmann perimeter was the most useful, the important features being depression of inner isopters and consistency of visual field defects. Inadvertent use of systemic corticosteroid may conceal the underlying process and lead to wrong diagnosis. Careful interview about the present history is another key to correct diagnosis.