耳管通気による気脳症にて発症した錐体部髄膜腫の1例

A Case of Petrous Ridge Meningioma Manifested as Pneumocephalus Followed by Eustachian Tube Insufflation

Ⅰ．はじめに

　日常の脳神経外科診療において，外傷や腫瘍，炎症による気脳症は比較的よく経験する病態である．今回われわれは，耳閉感に対し耳鼻科にて耳管通気が行われた後，気脳症を来した錐体骨縁部髄膜腫を経験した．稀な病態と考えられ，若干の文献考察を加え報告する．

　A 50-year-old female, who had a headache after Eustachian tube insufflation for her ear congestion, came to our hospital. CT and MRI revealed pneumocephalus and petrous ridge meningioma which destroyed petrous bone and air cells. Eustachian tube insufflation was considered to make the air coming into the middle ear, mastoid air cell and then into the intracranial space destroying the tumor. At surgery, there was subdural hematoma around the tumor. Total removal of the tumor and the hematoma membrane was performed. Histologically, the tumor was transitional meningioma and the cluster of meningioma cells were noted in the subdural hematoma membrane.