水頭症を伴ったPaget病の1例

Hydrocephalus in Paget's Disease: A case report

I．はじめに

　Paget病は1877年J．Pagetにより報告された原因不明の疾患である．本症では稀に正常圧水頭症の合併が報告されており^1-4,7,8），これに対してV-Pシャントが施行されている^2,8）．しかし術後の呼吸停止による急死の報告があり^3），安易なシャント術は危険である．われわれはV-Pシャント術後に脳室内圧を徐々に下げていく"軟着陸"法を行い，症状の軽快をみた例を経験したので，ここに報告する．

A case of Paget's disease in an elderly female who had a favourable evolution following ventriculoperito-neal (V-P) shunt is reported.

On May 28, 1983, a 52-year-old female was trans-ferred and admitted to us from the Dept. of Neuro-logy because of headache in the occipital region and ataxic gait.

On admission, neurological examinations revealed remarkably increased tendon reflexes, ataxic gait, and mild dementia. Headache was also observed, but urinary incontinence was not present.

Skull X-ray showed " cotton wool appearance ", which was characteristic of Paget's disease.