大脳縦裂部クモ膜嚢胞の3手術例

Interhemispheric Arachnoid Cyst: Report of three cases

I．はじめに

　クモ膜嚢胞はクモ膜が存在するあらゆる場所に発生可能であるが，その多くは脳槽に接して生じる．しかし大脳縦裂に発生し，組織学的にクモ膜嚢胞と診断された例の報告はわれわれの渉猟しえたかぎり，現在までに3例があるのみである．今回3例の大脳縦裂部クモ膜嚢胞を経験し，いずれも手術により良好な経過を得た，これら自験例をもとに治療上の問題点を中心に若干の文献的考察を加えて報告する．

Three operated cases of the interhemispheric arach-noid cyst were reported.

Case 1 : a 58-year-old female suffering from progres-sive right hemi-rigidity and gait disturbance for the past two years. Case 2: a 66-year-old female was admitted with chronic headache. MRI demonstrated a large interhemispheric cyst in these two patients. Case 3: a 6-month-old male had frequent episodes of tonic seizure. MRI demonstrated interhemispheric cyst and agenesis of the anterior part of corpus callosum.

The resection of the cystic wall via the interhemi-spheric approach was performed for all cases. General convulsive seizure developed in the early stage follow-ing operation in case 1 and case 2, in spite of routine administration of prophylactic anticonvulsant. The sei-zures were well controled thereafter. In all cases, the cyst disappeared on the follow up CT. Simple resection of cyst wall is effective in the surgical treatment of in-terhemispheric arachnoid cysts.