めまい，平衡失調を主症状とし，診断困難であつた星細胞腫（astrocytoma）の一剖検例

DIAGNOSTIC DIFFICULTY IN A CASE OF VERTIGO AND LOSS OF BALANCE THAT PROVED TO BE OF ASTROCYTOMA BY POST MORTEM EXAMINATION

　Ⅰ．緒言

　神経耳科学の進歩は各種の中枢性疾患の診断に大いに寄与しており，脳腫瘍の臨床においても，聴覚，平衡機能検査などの神経耳科的検査が病巣部位の判定に大いに役立つている。

　脳腫瘍のなかで，astrocytomaは比較的発生頻度も高く，かつ限局性に発育することが多いため部位診断も可能で，手術的摘出にもつとも適した腫瘍の一つであるといわれている。

　今回われわれは，めまい，平衡失調を主症状とし他の神経学的所見に乏しく，しかも早期に死の転帰をとつたため診断が困難であつたastrocytomaの興味ある一剖検例を経験したが，われおれの検索した限りでは，同様の報告は見出されなかつたので報告する。

　A case of astrocytoma in a woman, aged 31, whose chief complaints were vertigo and the loss of balance but meagre in other neurological manifestation, showed a diagnostic difficulty because the patient died early in the course of the disease. The result of the post mortem examination was studied from the standpoint of neuro-otology mainly associated with abnormal ocular movements during life.

　The spontaneous nystagmus was pointed to the right side; fixation nystagmus was pointed towards left and upwards and with the body at a recumbent position the nystagmus was pointed perpendicularly upwards. The optokinetic nystagmus showed a poor development when the object was moved clockwise.

　Post mortem examination revealed the tumor involving the midbrain, pons and the pyramid with edematous infiltration so that with a naked-eye it was difficult to differentiate between the normal and pathological tissues.