脊髄くも膜嚢腫—5例報告と文献的考察

Spinal Intradural Arachnoid Cyst:Report of five cases and a review of the literature

I．はじめに

　脊髄くも膜嚢腫は，先天性のもの以外に種々の炎症，出血，外傷など二次的変化により硬膜内に発生し，脊髄や神経根を圧迫したり，稀に硬膜を破って硬膜外におよび硬膜外腫瘍と同様の症状をきたすこともある^9,17）．

　硬膜内脊髄くも膜嚢腫の報告は少なく，われわれの例も含めて文献上67例を数えるにすぎない^9）．この理由として，①くも膜嚢腫があっても症状発現に至るものが少ない．②寛解，増悪をくり返す場合，ほかの疾患と間違われやすい，③診断，ことに脊髄撮影での読影が困難で，また技術の未熟さのため確定できない場合があることなどが考えられる．

Five cases of intradural arachnoid cysts were reported. Two rare cases were in cervical region, other three cases in thoracic region. Clinical and radiological findings were discussed in 67 cases including ours. All our cases with chronic clinical course except one showing spastic para-or tetraparese, sensory disturbance and gait disturbances were not much different to other reported cases in neurological findings.

Plain radiography, tomography and intravenous enhanced CT were not effective. In all of the casesspinal CT was performed following metrizamide myelography.