脳動静脈奇形手術後に生じたTrapped fourth ventricleの1例

A Case of Trapped Fourth Ventricle which developed after a Surgery of AVM

I．はじめに

　trapped fourth ventricleは，Luschka・Magendie孔および中脳水道の髄液通過障害により第4脳室が‘trap’され，嚢腫様に拡大する病態であり，多くは髄膜炎，くも膜下出血あるいは脳室シャントとの関連において報告されている．今回われわれは，側脳室三角部より中脳左側面の動静脈奇形摘出術後CT scanにて第4脳室の嚢腫様拡大を認め，Magendie孔開放術を施行したtrapped fourth ventricleの1例を経験したので若干の文献的考察を加え報告する．

We represent a case of cystic dilatation of the fourth ventricle resulted from obstruction of the foramina of Luschka and Magendie and of the aqueduct of Sylvius which developed after a surgery of AVM.

A 42-year-old woman was admitted to our clinic for the operation of AVM located at the trigone of lateral ventricle and the lateral wall of midbrain. VPS had been performed previously because of acute hydrocephalus resulted from several attacks of ventricular hemorrhage.