小児視交叉部腫瘍全摘術後に合併した硬膜下水腫—自験4例の検討

Subdural Effusion Following Radical Surgery for Chiasmal Region Tumors in Children:Report of 4 cases

I．はじめに

　小児に好発する頭蓋咽頭腫，視神経膠腫等の視交叉部腫瘍は，その発生部位の特性により，術後，尿崩症等の重篤な内分泌系の合併症を来たしやすく，術前術後管理の困難な腫瘍とされている．

　われわれは，これらの腫瘍に対して積極的に全摘術を施行し，良好な成績を収めてきたが，最近，これらの症例のなかには，かなりの高頻度で，術後，硬膜下水腫を合併してくるものが多いことに気づいた．

Four cases of subdural effusion following radical surgery for the chiasmal region tumors in childhood were presented in this report.

Three out of four cases were craniopharyngioma and the remaining one was optic glioma.

The pathogenetic mechanisms of this disorder were explained probably and at least partly by a change from internal to external hydrocephalus or craniocerebral disproportion due to cerebral atrophy in two of the four cases and unclear in the remaining two cases. In all four cases meningitis did not supervene postoperatively.