視機能障害で発症した結核腫の1手術例

A Surgical Case of Tuberculoma with Visual Disturbance

Ⅰ．はじめに

　脳槽内石灰化病変を来す疾患は極めて稀であるが，なかでも結核性髄膜炎は脳槽内を中心に炎症を来し，結核腫といった腫瘤性病変を来すことが知られている¹⁹⁾．今回われわれは，結核性髄膜炎に起因する結核腫による視索圧迫にて視機能障害を来した1手術例を経験したため，文献的考察を加えて報告する．

　We herein report a surgical case of multiple cerebral calculi located within the chiasmatic cistern resulting in visual disturbance. A 61-year-old man experienced homonymous lower right quadrantanopsia a few years prior. Non-enhanced head CT revealed multiple calcified lesions of about 7-mm within the basal cistern. MRI showed the lesion compressing the left optic tract. We could not remove the entire lesion because of severe adhesion to the optic tract. A pathological test showed calcified lesions with lymphocyte infiltration. We diagnosed tuberculoma caused by tuberculous meningitis with degeneration of the calcified lesion because of a history of tuberculosis at a fetal age. After the surgery, the patient was discharged without improvement of the visual disturbance.