成人型Chiari奇形の5手術例

Adult Chiari malformation:Five operative cases

I．はじめに

　Chiari I型奇形は，多くは成入に認められるが，その症状はしばしば多彩であり，他の大孔部奇形，syringo-myelia，頸髄腫瘍などとの鑑別は必ずしも容易でない．また前二者とは，Chiari奇形そのものが合併して認められることもあり，診断上注意を要する．しかし，highresolution CTの登場により，頸部のかなり詳細な所見を非侵襲的にとらえることが可能となり，特にCT me-trizamide myelographyを行うことにより比較的容易に本症の診断ができるようにな一、た．著者らはCT metri-zamide myelography導入後2年間で5例の成人型Chiari奇形患者を経験し，手術を行ったので報告し，若干の考察を加える．

Recently, the diagnosis of adult Chiari malformation seems to have easy, because of the development of high resolution CT. During the last two years, we experienced with five cases of adult Chiari malforma-tion diagnosed by CT metrizamide myelography. There were two males and three females aged from 15 to 55 years. Three cases had both foramen magnum compression and cerebellar symptoms. One of them had lower cranial nerve symptoms too. Another case had central cord symptoms, and the rest of them complained only of headache and vertigo.

All cases underwent suboccipital craniectomy and upper cervical laminectomy.