乳児の脳腫瘍

BRAIN TUMORS OF EARLY INFANTS

Ｉ．はじめに

　小児，すなわち15歳未満の脳腫瘍についての記載は多く，その特徴も成人の脳腫瘍とは種々の点で異なることが多いことはすでに，衆知の事実である。しかしながら，小児のうちでも，1歳未満の乳児の脳腫瘍についてみると，小児一般の脳腫瘍とは，その趣を異にしている。しかも，これらの脳腫瘍では，その発生の原因が，やはり先天性のものと考えられ，確かに，報告上，病理学的にも，teratomaが多い。しかし，gliomaも比較的多く，これが成人のgliomaと病理学的に何らかの差異がみられるか否かは，興味のある所である。

　さらにまた，近来，脳血管撮影，脳室撮影，脳scan，isotope cisternography, ventriculographyなどの補助診断技術の進歩により，以前ならば，水頭症，慢性硬膜下血腫と考えられたような症例が，実は脳腫瘍であることが判明する機会も増え，これら乳児の脳腫瘍の治療が問題となるようになつた。

Brain tumors of early infants less than one year of age are rare and we have so far experienced only ten such cases. The frequency was 0.4% in the whole intracranial neoplasms and 1.9% in children's tumor cases less than 15 years of age in our series.

The clinical features were simulating hydro-cephalus, chronic subdural hematoma or-hygroma. But considering for the focal neurological signs or convulsion and findings of cerebral angiography and ventriculography, the diagnosis for brain tumors was not difficult.

In nine cases the tumors were located supraten-torially, and among those, the tumors were within the ventricle in five cases.

The pathology of tumors was 5 gliomas, 2 tera-tomas and each one case of craniopharyngioma, sarcoma and choroid plexus papilloma.

In nine cases craniotomy was performed and in a case of craniopharyngioma, only ventriculopleural shunt was performed because of poor conditions.

The effect of adjuvant therapies was satisfactory and the prognosis was relatively fair excluding early dead cases soon after the operation.