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Neurological Surgery No Shinkei Geka Volume 20, Issue 6 （June 1992）

Neurological Surgery 脳神経外科 20巻6号（1992年6月発行）

Japanese English

症例

Disproportionately Large，Communicating Fourth Ventricleの4例—特にIsolated Fourth Ventricleとの病態の違いについての考察 Disproportionately Large, Communicating Fourth Ventricle; Report of 4 cases 黒木貴夫 ¹ , 松元幹郎 ¹ , 大石仁志 ¹ , 山下晃平 ¹ , 周郷延雄 ¹ , 寺尾榮夫 ² , 串田良昌 ³ Takao KUROKI ¹ , Mikiro MATSUMOTO ¹ , Hitosi OHISHI ¹ , Kouhei YAMASHITA ¹ , Nobuo SUGO ¹ , Hideo TERAO ² , Yoshimasa KUSHIDA ³ ¹東邦大学佐倉病院脳神経外科 ²東邦大学脳神経外科 ³済生会横浜市南部病院脳神経外科 ¹Department of Neurosurgery, Sakura Hospital of Toho University Medical School ²Department of Neurosurgery, Toho University Medical School ³Department of Neurosurgery, Saiseikai-Yokohama Nanbu Hospital キーワード： Fourth ventricle , Aqueduct , V-P shunt Keyword: Fourth ventricle , Aqueduct , V-P shunt pp.707-711

発行日 1992年6月10日 Published Date 1992/6/10

DOI https://doi.org/10.11477/mf.1436900482

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Abstract 文献概要
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I．はじめに

　1983年，われわれが本邦で初めてScottiにより提唱された“Disproportionately large, communicating fourthventricle^17）（DLCFVと略す）の2症例を報告^9）して以来，その報告例も散見されるようになった．しかし，それらの報告例の中には”Isolated fourth ventrlcle"（IFVと略す）との異同が問題となる症例などもあり，DLCFVの病態はまだ十分には分析されていない．今回，われわれの経験したDLCFVの4例と文献上報告されているIFVとを比較検討し，DLCFVとIFVの病態の違いと，DLCFVの発生機序について考察した．

Although both “Isolated Fourth Ventricle” (IFV) and “Disproportionately Large, Communicating Fourth Ventricle” (DLCFV) are the clinical-radiologic entities characterized by a dilatation of the fourth ventricle, DLCFV must be separated from IFV because of its apparent patency of the aqueduct. In some Japanese literature, however, there was some confusion concern-ing DLCFV and so-called “reversible DLCFV” or IFV with “one way aqueduct”.

In this paper, comparing DLCFV with IFV, a reaso-nable pathogenesis of DLCFV was discussed on the basis of clinico-radiological analysis of four cases of DLCFV.

Our tentative conclusion is as follows : 1) Whether there is radiologic aqueductal patency or not, the term of DLCFV should not be primarily reserved for pa-tients who have had shunting of the lateral ventricle for previous hydrocephalus.“ 2) It was strongly suggested that a mechanism involved in the development of DLCFV was the formation ”membranous occlusion" in/ or near the foramen Magendie.