Terson症候群を呈した上小脳動脈分岐部破裂動脈瘤の1例:症例報告と報告例32例の検討

Terson's syndrome which arose from ruptured right superior cerebellar artery aneurysm:a case report and 32 series investigations

I．はじめに

　くも膜下出血に伴う眼球内出血の中でTerson症候群として知られる硝子体出血（vitreous hemorrhage：VH）の報告は少ない^{6-8,11,18,21-23,25,28,29,31）}．今回著者らは，右上小脳動脈分岐部動脈瘤破裂によるTerson症候群^26）の1例を経験したので，従来の報告と合わせてとくにその統計学的検討と発生病態につき文献的考察を加えて報告する．

The case reported here was a 50-year-old woman with the onset of generalized convulsion and vomiting on November 22, 1993. At admission, her neurological sings and symptoms were classified as Hund & Hess grade IV, and precise examination revealed subarach-noid hemorrhage by rupture of aneurysm at the bran-ching of the right superior cerebellar artery. Thus neck clipping was performed on the same day. Although her consciousness level gradually improved after operation, she complained of left vision disturbance on December 5 (14 days after onset). The visual acuity of the left eye was manual valve of 30cm. It was precisely ex-amined using fundoscopic examination and B mode ultrasonography making the diagnosis of left vitreous hemorrhage (Terson's ryndrome). The visual acuity of the left eye began to improve on December 12, and was found to be 1.0 on November 18, 1994, about 1 year af-ter onset. The hemorrhage was also determined to be almost completely absorbed by fundoscopic examina-tion. In this report, the results of statistical analysis of 32 previous cases, in addition to our case, are described, together with the discussion on the pathogenesis of Terson's syndrome.