限局性錐体路変性を示した脳橋底部軟化の一症例

A CASE OF THE SOFTENING OF THE PONS BASE WITH LOCALIZED DEGENERATION OF THE PYRAMIDAL TRACT AT THE MEDULLA

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　我々は最近生前左片麻痺を伴う二回の脳卒中発作を呈し，死後剖検により脳橋の限局性軟化と延髄錐体路の限局性変性を認めた興味ある症例を経験したので，この臨床所見と剖検所見を対比して考察してみたいと思う。

A 75-year-old man with two episodes of the cerebral vascular accidents of the same side was hospitalized complaining of left he-miplegia, speech disturbance, dysphagia and bladder disturbance. For last 27 years he has suffered from diabetes mellitus and since several years pulmonary tuberculosis. As he came down with a severe bronchitis with continuous high fever just before hospitali-zation, his general status has become very poor showing severe emaciation, hypotension and neurological manifestations has progress-ed without new attacks. Death ensued rather suddenly three months after hospitalization, when patient went in coma accompanied with muscular twitching of left periorbital and perioral muscles.

At autopsy, arteriosclerosis of the medial cerebral and basilar artery was severe but not occluded. Localized softening was observ-ed in the right caudal and medial part of the base of the pons, which was supplied by the right paramedian artery.

Secondary degeneration was found in the medial half of right pyramid of the medulla, corresponding to the lesion of the pons.