気管支喘息様発作を伴って発症した第4脳室Epidermoidの1例

A Case of Epidermoid in The Fourth Ventricle Associated with Bronchial Asthma-like Symptom

I．はじめに

　頭蓋内epidermoidは，脳腫瘍全国統計（1969-1981）では全脳腫瘍の約0.9％と比較的稀な腫瘍であり，脳底傍正中部の小脳橋角部，傍トルコ鞍部がその好発部位で，第4脳室に発生することは極めて稀で，頭蓋内epidermoidの約7％にすぎない．第4脳室epidermoidに特徴的な症状はないが，歩行障害，頭痛，めまい等で発症することが多い．今回，われわれは嘔気，嘔吐で発症し，その後喘息様発作を来した極めて稀な第4脳室epidermoidを経験したので，若干の文献的考察を加えて報告する．

A case of large epidermoid located in the fourth ven-tricle is presented, and the patient's uncommon symp-tomatology of bronchial asthma-like episode is discus-sed. The value of magnetic resonance imaging (MRI) is also emphasized in the diagnosis of intracranial epidermoid.

A 41-year-old male noticed nausea and vomiting on getting up in the morning about 5 years ago. This was followed by bronchial asthma-like dyspnea one year la-ter. About one week prior to admission, headache and gait disturbance started. On neurological examination, he had choked disk and horizontal nystagmus at lateral gaze bilaterally.