脳腫瘍における大脳半球剔除について

CEREBRAL HEMISPHERECTOMY FOR TUMOR

緒言

　大脳半球剔除は1923年脳腫瘍患者にDandy^4）5）が施行し，之を1928年報告しているのが嚆矢であり，其の後O’Brien^21）22），Zollinger^26）27），Ro-we^23），Gardner^10），Karnosh^14），Karnosh and　Gardner^15）Bell and Karnosh^2）Marshall and　Walker^18）等が脳腫瘍の場合の大脳半球剔除を報告しているが，1950年迄の報告例は第1表の如く，著者等の集め得たものは23例に過ぎない。

　之に反し1950年以降は，Krynauw^16）17）がIn-fantile hemiplegiaに対し大脳半球剔除の著効を報じて以来，Infantile hemiplegiaに就いての剔除例が急増し，Obrador and Larramendi^20），Crains and Davidson^3），Tönnis^24），Daniel Fe-rey^6），French, Johnson, Brown and Van　Bargeng^9），Uecker, French and Johnson^25）等多数の報告が見られ，本邦に於いても植木^29）30），渡辺^31），金谷^28），西本^32）等の報告が見られ，Infa-ntile hemiplegia特に癲癇痙攣を伴う症例に於ける大脳半球剔除の意義が確認され，手術症例は益々増加しつつある現状である。

A 16-years-old boy, sufferd from the repea-ted reccurrence of glioma of right temporopa-rietal lobes, was treated by the exstirpation of right cerebral hemisphere in one piece, including right thalamus.

The microscopic diagnosis of the specimen at the first operation, carried out in 12-years-old, was astrocytoma, but the microscopic findings of the removed hemisphere revealed astrocytoma in one part and oligodendroglio-ma and glioblastoma multiforme in another parts.

Postoperatively he could move roughly the left extremities and his intelligence was not so damaged but he could not walk without the relief by his family.

He died about one year later.

The authors think from above mentioned result that cerebral hemispherectomy is one of the treatments for repeatedly reccured or malignant changed brain tumors, but the period of this operation is not to be too late and then preoperatively the social indication is to be examined carefully.