腫瘍摘出後に一過性有形性幻視をきたした右側頭頭頂部髄膜腫の1例

Formed Visual Hallucination after Excision of the Right Temporo Parietal Cystic Meningioma : A Case Report

はじめに

　有形性幻視は，まとまった形を有する幻視が視野欠損部分や視野全体にみえる現象である。原因病巣としては側頭―後頭葉や頭頂葉下部の病変によって出現するとされる。原因疾患としては脳梗塞や皮質下出血などによって生じた例の報告がみられるが，髄膜腫摘出後に生じた症例の報告は少ない。今回，髄膜腫摘出後に一過性の有形性幻視を認めた症例を経験したので報告する。

Abstract

　We report the case of a 64-year-old woman with cystic meningioma; this patients was otherwise healthy and experienced formed visual hallucinations after excision of the tumor.　She experienced diplopia associated with metamorphopsia, which had persisted for 5 years only when she laid down and turned on her left side.　After the excision of the convexity meningioma located in the right temporoparietal lobe, she experienced several types of formed visual hallucinations such as closet-like pictures, flowers sketched on stones, falling maple-like leaves, and moving or wriggling dwarves.　She was alert and her visual field was normal; further, she did not experience delirium or seizures.　She experienced these hallucinations only when she closed her eyes; these hallucinations persisted for 3 days after the operation.　The patient illustrated her observations with beautiful sketches, and the mechanism of visual hallucinations was studied. （Received: December 16,2009,Accepted: March 2,2010)