スパイナルドレナージ後に軽快した顔面痙攣の1症例

Disappearance of Hemifacial Spasm Following Spinal Drainage: A case report

I．はじめに

　腫瘍や血管腫などによらない，いわゆるidiopathicな顔面痙攣（hemifacial spasm（HFS））の成因として，neurovascular compression theoryを考えるものが多い^3,4）．実際にHFSに対してmicrovascular decompres—sion（MVD）が行われ良好な成績が得られている^4,5）．

　未破裂脳動脈瘤と反対側のHFSを合併した患者に，動脈瘤のネッククリッピングを行ったが，その際に蝶形骨洞が一部分開放された．そのため，髄液鼻漏の発現を予防する目的でスパイナルドレナージを施行したところ，約2週間後にHFSが軽快した．

This report is concerned with a case of right hemifa-cial spasm (HFS) occurring in a 65-year-old woman, who incidentally had a left internal carotid-ophthalmic artery aneurysm.

The aneurysm was successfully treated by clipping its neck. However, spinal drainage had to be performed postoperatively in order to prevent possible cerebro-spinal fluid (CSF) rhinorrhea, as the roof of the sphe-noid sinus was accidentally opened during the aneurysm surgery. Liquorrhea was observed and stop-ped on the 5th postoperative day.