透明中隔腔およびVerga氏腔嚢包—その手術の1考案

Cyst of the Cavum Septi Pellucidi and Cavum Vergae A Contribution to its Operative Treatment

　透明中隔腔嚢包およびVerga氏腔嚢包については，Andrea Verga （1851）以來少からぬ報告がなされているが，1931年Dandy　^1）2）が手術に成功した2例を報告するまでは，そのほとんどすべては剖檢例のみであつたその後Van Wagenen　＆　Aird，　^17）　Wilder，　^19）Pardee，^11）Jaeger　＆　Bannwarth，　^3）　Love, Cap　＆　Eaton^6）scott^15）Miller^9）等の手術例が發表された。わが國では淸水（1937）の臨牀，剖檢例，長田（1940）^10）の報告（減壓開頭術施行）のほかはこれに關係した論文を知らない最近われわれは定型的な透明中隔腔およびVerga氏腔嚢包の1例を經驗し，これに第3腦室嚢包間造瘻術なる新手術を試み約1年間の觀察で良効を確認するに至つたのでここに報告する。

There have been many reports concerning the operations for cysts of cavum septi pellu-cidi or of cavum Vergae, since the first succ-esful case operated by Dandy in 1931. Recently the authors had one case, upon which they operated by the following method with good result.

The patient was a 41-year-old house-wife and was perfectly well until 3 years before admission, when she became aware of dysme-norrhea and gradually increasing adiposity. Nuchal stiffness, headache, vomiting, fainting spells, blurred vision (choked disc), polydipsia and polyuria developed in succession. She was admitted tothe hospital in March 1950, as abrain tumor suspect. Lumbar puncture: pressure of-250mm. of water; chemical analysis normal; Wassermann reaction negative. Ventriculogra-phy revealed communicating cyst of cavum-septi pellucidi and cavum Vergae.

Craniotomy was made and the cyst wall was-perforated by transventricular approach after Van Wagenen and Aird so as to anastomose the right lateral ventricle and the cyst. After the operation the patient's symptoms were improved, but about 10 days after, they slowly recurred and polyuria became tremendous.

The cause was cosidered to be pressure of the cyst on the foramina of Monroe, which. disturbed inter-communication between the 3rd ventricle and lateral ventricles, so the anastomosis between the lateral ventricle and the cyst seemed ineffectual.

The authors reopened the cranium and at-tempted to establish inter-communication be tween the lateral ventricle and the cyst, then the cyst and the 3rd ventricle by perforating. the cyst floor.

Postoperatively she showed marked impro-vement and was discharged 3 weeks later.. Sub-sequent course was uneventful except the se veral attacks she had 5 months after, which could be controlled by medication.

At present, more than one year after the operation, she is quite well and leading a no rmal life without any of the symptoms she had before.