神経耳科学的検査が診断の重要な手がかりとなった転移性小脳腫瘍症例

Metastatic Cerebellar Tumor found by Neuro-Mtological Examinations; A Case Repor

Ｉ．はじめに

　頭位性眩景を訴える疾患には末梢内耳障害による良性発作性頭位性眩暈がまず第一に挙げられるが，これに対して中枢性の障害によるものもあることを常に念頭に置いて日常臨床に当たらなければならない。

　すなわち仮性良性発作性眩暈^1）と悪性発作性頭位性眩暈^2）がそれであり，後者はその原因として後頭蓋窩の出血，腫瘍，血管障害などがある。今回われわれは頭位性眩景を訴える原発性肺癌患者で，神経耳科学的検査によって小脳転移が疑われCT scanでその存在が確認され，しかも化学療法の結果症状の軽快とともに腫瘍陰影の著明な縮小をみた興味ある症例を経験したので報告し，諸家の御参考に供する。

There are two types in the "positional vertigo", which arc (1) caused by peripheral inner ear disease and (2) caused by central lesion. The latter is furthermore divided into "pseudo malig-nant type" and "malignant type". The latter is also called as "Bruns syndrome".

We have experienced a patient with small cell carcinoma of the lung, who complained of posi-tional vertigo. Neurological findings were very scanty, on the other hand by the neurotological examinations we could suspect a metastatic tumor in the cerebellum.

The lesion was confirmed by CT-scan. Chemo-therapy was performed, then clinic-al course was successfully improved. Finally the mass lesion almost vanished on CT-scan.