脳膿瘍後早期に発症した脊髄空洞症の1例

Syringomyelia appearing in a short term after brain abscess

I．はじめに

　種々の炎症性疾患を原因とした脳底部くも膜炎を誘因として，脊髄空洞症が発生することはよく知られているが，日常実際に経験することは少なく，また報告されているものの多くは数年以上という長期を経て発症している^4,8,11,14）．今回われわれは脳膿瘍の発生から数カ月で脊髄空洞症を呈した症例を経験したので，その発生機序，治療法について若干の文献的考察を加えて報告する．

We describe a rare case of syringomyelia that de-veloped within only 4 months after the cure of the focal cerebritis and abscess. An 18-year-old man who had suffered from meningitis and brain abscess 1.5 years before, presented with pain and sensory disturbance in his left shoulder. Magnetic resonance image (MRI) showed a syrinx formation extending from the upper cervical to the lower thoracic cord. Investigation by MRI during the course of the brain abscess had the appearance of posterior cerebellar arachnoid cyst 3 months after the onset of brain abscess and syrinx de-veloped within 9 months.

After posterior fossa decompression and reopening of the Magendie's foramen, his symptom and MRI abnor-mality improved after one month.

In contrast to reported cases of syringomyelia follow-ing cerebritis, syrinx formation in our case appeared in relatively a short time.

We speculated that basal arachnoiditis and the forma-tion of posterior cerebellar arachnoid cyst caused syrinx formation in a short term after cerebritis.