特発性脳脊髄液鼻漏

SPONTANEOUS CEREBROSPINAL RHINORRHEA:REPORT OF A CASE

I．はじめに

　特発性脳脊髄液鼻漏spontaneous or idiopathic cer—ebrospinal fluid rhinorrheaなる語は，何ら認むべき原因なくして脳脊髄液が鼻腔内に出現しきたる状態に対して与えられた名称であるが，きわめてまれなもののようである。欧米においては1947年Coleman and Troland^2）が文献上に12症例を集め，自験3例を追加報告して以来，今日までに数例の追加報告が発見されるにすぎない。本邦においてはいまだにかかる症例の報告はなされておらず，以下に記するわれわれの症例が最初のものである。

The name of spontaneous cerebrospinal rhinorrhea is given to the state in which the cerebrospinal fluid is discharged through the nasal cavity without any causative conditions. In foreign literature Coleman and Troland published a collective review in 1947. Thence some other cases have been reported but undoubtedly it is a very rare condition.

In Japanese literature we have not found any single case reported. So our case reported here is the first one in Japan. The case was a female aged 26. She com-plained of such headache and rhinorrhea as in common cold. Her illness was diagnosed as meningitis and hemolytic streptococci was found in the cerebrospinal fluid. The chemotherapy was given and her headache disappeard and cerebrospinal fluid became clear. But her watery rhinorrhea was persistent. Her frontal fossa was explored and treated according to the method of Troland. Immediately after operation her rhinorrhea ceased.

In her previous history she was treated under the diagnosis of meningitis 7 years ago. Thus her history suggest an intermittent cerebrospinal rhinorrhea with concomitant bacterial infections.