上方注視麻痺を呈した非腫瘍性Pineal cystの1治験例

A Case of Non-neoplastic Pineal Cyst Presenting Parinaud's Syndrome

I．はじめに

　剖検例において松果体に光顕レベルでsmall cystを認めることは稀ではないが，臨床上四丘体を圧迫して上方注視麻痺をきたしたり，中脳水道を閉塞して水頭症をひき起こすような大きな非腫瘍性pineal cystの存在は稀である上また，pineal cystがmetrizamide CTcisternographyによって明瞭に描出されている症例の報告は見当たらない．今回われわれは上方注視麻痺を呈した松果体部非腫瘍性pineal cystの1例を経験し，metrizamide CT cisternographyにて明瞭にcystが描出され，手術にて症状の改善が認められたので文献的考察を加え報告する．

A case of non-neoplastic pineal cyst with Parinaud's syndrome is presented. A 54-year-old woman was admitted to the department of neurosurgery, Fukui Medical School on October, 1985, complaining of the paralysis of upward gaze. A computed tomo-graphy (CT) demonstrated a low density mass in the pineal region and the mass was not enhanced after the injection of contrast agent. Metrizamide CT cisternogram delineated the mass clearly. Bilateral carotid and vertebral angiograms showed no signi-ficant findings. On November 5, an operation was performed by means of an occipital transtentorial approach.