脊髓膿瘍の一例

A Case of Spinalabscess

1．序言

　脊髄に限局した膿瘍に関する症例報告は，，従来極めて稀れであり，Bodechtelによれば，1953年迄の解剖学的報告は30例に満たず，その臨床診断は，大体に於て困難とされている。著者は始め，破傷風と誤診された本例の病理組織学的検索例を得たので，茲に報告する。

Patient: 30 years old man, a vagrant. Clinical findings: The most marked were stiffness of posterior neck muscles, and successive attacks of tonic convulsion. Trism, tetanoid counte-nance and a quail egg sized abcess in palm were observed. Temperature: 37.6℃, Respira-tion: 30, Pulsrate: somewhat quickened, Knee jerks: exaggerated in medium grade. No dis-turbance of consciousness. Clinical diagnosis: Tetanus. Course: Death after 6 days from the onset. Histopathological findings: Corres-ponding from the lowest part of medulla to upper parts of cervical cord, several milliar sized abscesses were observed in white matter especially in pyramidal areas. Infiltration of leucocytes were also marked along with neighbouring vessels and pia mater.

Moreover,pathologic changes of the brain, which seem to due to septicaemia and agony were pointed out.

Authors would like to conclude these teta-noid symptoms of the case, as the result of spinal metastasis of palmal abscess that is, of so-called myelitis acutissima.