動眼神経麻痺を主徴とした脳下垂体卒中の1例

Pituitary Apoplexy with Oculomotor Palsy:Case Report

Ⅰ．はじめに

　脳下垂体腺腫に伴って突然発症する頭痛，意識障害，視力障害をきたす脳下垂体卒中に関する報告は少なくないが，我々は最近，動眼神経麻痺と髄膜刺激症状で発症し，臨床症状から内頸動脈瘤を疑った1例を経験したので報告する．あわせて下垂体卒中発症のメカニズム、および動眼神経麻痺発現の機序について若干の文献的考察を行った．

A case of 36-year-old house wife who has been amenorrheal since 16 years ago, suddenly developed headach, nausea and disturbance of consciousness. On the following day she was noticed to have the right palpebral ptosis and was referred to our department.

Neurological examination showed the right oculomotor palsy and bitemporal upper quadrantanopia On perimetry examination. Spinal tap showed the increased intracranial pressure and xanthochromic CSF. Carotid angiography and pneumocisternography revealed a pituitary tumor protruding mainly in the right side of the sella turcica.