高齢者キアリⅠ型奇形の1手術例

A Surgical Case of Chiari Malformation Type Ⅰ in Elderly Patient

キアリⅠ型奇形は小脳・脳幹の一部が大後頭孔を越えて脊柱管内に陥入する病態で，大部分の症例は無症候性であるが，さまざまな症状を呈する場合がある。症候性の場合，小児・中高年の二峰性分布を示し，高齢者には稀とされている。われわれは60歳を越えてから発症し，手術によって良好な転帰が得られたキアリⅠ型奇形の1例を経験し，高齢で発症する機序について文献的考察を加え報告する。

Abstract

Chiari malformation type I (CM-1) is a disease in which part of the cerebellum and brainstem invades into the spinal canal beyond the foramen magnum. Patients with CM-1 can present with various symptoms; however, most cases of CM-1 are asymptomatic. Symptomatic cases are distributed bimodally in children and middle-aged adults, but occur very rarely in elderly individuals. We experienced a case of CM-1 onset after the age of 60 years that followed a favorable postoperative course. We report the potential mechanism of asymptomatic CM-1 in elderly patients along with a review of the literature.