脊髄性くも膜下出血を来した馬尾神経鞘腫

Spinal Subarachnoid Hemorrhage due to a Neurinoma of the Cauda Equina

I．はじめに

　脊髄くも膜下出血は比較的稀な疾患であり，くも膜下出血の約1％を占めると言われている．その原因疾患としては脊髄血管奇形，外傷や血液疾患（白血病，血友病，出血性素因）などが知られている．しかし，脊髄腫瘍が原因となるくも膜下出血は稀である．

　出血を来す腫瘍の多くはependymomaであり，caudaequinaのneurinomaがくも膜下出血を来した報告例はきわめて少ない^14）．

A case of neurinoma of the cauda equina which showed spinal subarachnoid hemorrhage was reported.

A 39-year-old man was admitted to our hospital be-cause of left lumhoischalgie, on August 7, 1987. Myelography disclosed a round mass at L2, and cere-brospinal fluid was slightly xanthochromic. MRI de-monstrated a round isointensity mass by T1 weighted image, and slightly high intensity by T2 weighted image.

On August 26, 1987, the patient developed sudden onset of headache, but his headache disappeared under medication.

On August 27, 1987, laminectomy L1-3 and total re-moval of the tumor were carried out.