脊髄損傷における遅発性交代性ホルネル徴候

Late Manifestation of Alternating Horner's Signs in Spinal Cord Injury clue to Dura-cord Adhesion

Ⅰ．はじめに

　脊髄損傷の患者に，遅発性の一過性交代性ホルネル徴候を認める事があり，その原因は脊髄内の空洞形成で，その中の液体の移動による自律神経系の刺激によると言われている^4,18）．

　今回われわれは，同様の症状を訴え来院した患者に，手術時，硬膜と損傷脊髄との強い癒着以外に，穿刺によっても空洞形成を認めなかった症例を経験した．そのため，手術では癒着剥離以外には何も行わなかったのに，術後著明な症状の改善を認めた．

　It has been said that late manifestation of transient alternating Horner's signs in cases of spinal cord injury is caused by intramedullary cavity formation in which some movement of fluid stimulates the sympathetic system corresponding to their positioning.

　We had a patient complaining of alternating Horner's signs which became manifest 8 years after the injury. We could not find any intramedullary cavity formation, in spite of a spinal puncture at operation, but the symptoms made a striking improvement after the operation simply by making free the spinal cord from the dura mater at operation.