軽度外傷後に生じたと思われる脊髄髄内空洞（嚢胞）の1例

A Case of Intramedullary Spinal Cavitation after Minor Trauma

I．はじめに

　脊髄外傷を契機として，脊髄髄内に空洞を形成する外傷性脊髄空洞症は，脊髄外傷症例の0.3-3％に生ずる比較的稀な疾患とされているが，近年MRI等の画像診断の発達にともない脊髄髄内疾患への関心が高まり外傷性脊髄空洞症の報告例も散見されるようになってきた．しかしながらこれらの報告の多くは，対麻痺・四肢麻痺を生ずる重症の外傷後に発生したものであり，軽微な外傷後の報告例は少ない．

　今回著者らは，軽度の頸椎外傷に起因したと思われる脊髄髄内空洞（嚢胞）の症例を経験したので，その臨床経過と発生機序に関し若干の文献的考察を加え報告する．

A case of surgically treated intramedullary spinal cavity which appeared 1 year after a minor injury was presented. A 15 year-old boy developed nuchalgia and muscle weakness of his right arm and leg. On admis-sion, he had right hemiparasis and sensory disturbances in the right C6 - C8 and left T1 - S5 dermatomes. Met-rizamide-CT scan and MRI disclosed an intramedullary spinal cavity between C4 - C5 vertebral levels. A myelotomy and a biopsy of the cavity wall were carried out in order to communicate the cavity with the sub-arachnoid space, and to make a definite diagnosis.