Neurological Surgery 脳神経外科34巻1号

2006年01月発行

症例

後頭葉のpilocytic astrocytoma摘出により治癒し得た片頭痛の1例

著者： 北川雅史¹ 佐藤岳史¹ 石崎竜司¹ 齊木雅章¹

所属機関： ¹滋賀県立成人病センター脳神経外科

ページ範囲：P.59 - P.64

Ⅰ．は じ め に

　片頭痛は頭痛発作を繰り返す疾患で，中枢神経系の神経細胞の興奮性亢進によって起こるとされている．臨床においては比較的頻繁に遭遇する疾患であり（本邦では8.4%²²⁾，アメリカ合衆国では女性17.2%，男性6.0%¹⁵⁾），スマトリプタンの出現により，一般内科においても治療されるようになっている²⁴⁾．通常は器質的異常を伴わないが，片頭痛と脳虚血との関連に関しては比較的多くの報告があり，その発生メカニズムが議論されてきた^18,19)．また，片頭痛と頭蓋内占拠性病変の合併についても報告が散見される^{1,5,7,11,14,16,17,20,21,23,25,26,28)}が，その頻度は極めて稀である（0.2%^11,27)）．今回われわれは，典型的なmigraine with auraで発症した右後頭葉のpilocytic astrocytomaの1症例に対し，摘出術を行い，術後片頭痛の消失をみた．片頭痛と頭蓋内腫瘍との関連について，文献的な考察を加え報告する．

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