Neurological Surgery 脳神経外科37巻9号

2009年09月発行

研究

脳腫瘍による三叉神経痛症例の臨床的検討

著者： 仲川和彦¹ 青柳傑¹ 河野能久¹ 大野喜久郎¹

所属機関： ¹東京医科歯科大学脳神経外科

ページ範囲：P.863 - P.871

Ⅰ.はじめに

　三叉神経痛（trigeminal neuralgia：TN）はroot entry zone（REZ）を血管が圧迫することで起こること以外に，小脳橋角部（cerebellopontine angle：CPA）腫瘍が原因となる場合もある．TNを起こす主な腫瘍は，類上皮腫，聴神経鞘腫，髄膜腫で，本邦では類上皮腫が多い^{2,4-6,8-10,15)}．今回，TNを発症した脳腫瘍症例について，臨床的検討を行った．

参考文献

1）Akimoto H, Nagaoka T, Nariai T, Takada Y, Ohno K, Yoshino N：Preoperative evaluation of neurovascular compression in patients with trigeminal neuralgia by use of three-dimensional reconstruction from two types of high-resolution magnetic resonance imaging. Neurosurgery 51：956-962, 2002

2）Barker Ⅱ FG, Jannetta PJ, Babu RP, Pomonis S, Bissonette DJ, Jho HD：Long-term outcome after operation for trigeminal neuralgia in patients with posterior fossa tumors. J Neurosurg 84：818-825, 1996

3）Chen S, Ikawa F, Kurisu K, Arita K, Takaba J, Kanou Y：Quantitative MR：evaluation of intracranial epidermoid tumors by fast fluid-attenuated inversion recovery imaging and echo-planar diffusion-weighted imaging. AJNR Am J Neuroradiol 22：1089-1096, 2001

4）長谷川浩一，近藤明悳，絹田祐治，田辺英紀，川上雅久，松浦伸樹，沈　正樹，斉木雅章：小脳橋角部腫瘍により発症した三叉神経痛45例の検討．No Shinkei Geka 23：315-320, 1995

5）Kobata H, Kondo A, Iwasaki K：Cerebellopontine angle epidermoids presenting with cranial nerve hyperactive dysfunction：pathogenesis and long-term surgical results in 30 patients. Neurosurgery 50：276-286, 2002

6）Nomura T, Ikezaki K, Matsushima T, Fukui M：Trigeminal neuralgia：differentiation between intracranial mass lesions and ordinary vascular compression as causative lesions. Neurosurg Rev 17：51-57, 1994

7）大野喜久郎：三叉神経痛．No Shinkei Geka 28：939-950, 2000

8）Samii M, Tatagiba M, Pique J, Carvalho GA：Surgical treatment of epidermoid cysts of the cerebellopontine angle. J Neurosurg 84：14-19, 1996

9）Samii M, Carvalho GA, Tatagiba M, Matthies C, Vorkapic P：Meningiomas of the tentorial notch：surgical anatomy and management. J Neurosurg 84：375-381, 1996

10）Samii M, Matthies C：Management of 1000 vestibular schwannomas (acoustic neuromas)：surgical management and results with an emphasis on complications and how to avoid them. Neurosurgery 40：11-23, 1997

11）Seidel E, Hansen C, Urban PP, Vogt T, Müller-Forell W, Hopf HC：Idiopathic trigeminal sensory neuropathy with gadolinium enhancement in the cisternal segment. Neurology 54：1191-1192, 2000

12）Sindou M, Leston J, Decullier E, Chapuis F：Microvascular decompression for primary trigeminal neuralgia：long-term effectiveness and prognostic factors in a series of 362 consecutive patients with clear-cut neurovascular conflicts who underwent pure decompression. J Neurosurg 107：1144-1153, 2007

13）Tamura K, Aoyagi M, Wakimoto H, Tamaki M, Yamamoto K, Yamamoto M, Ohno K：Malignant transformation eight years after removal of a benign epidermoid cyst：a case report. J Neurooncol 79：67-72, 2006

14）Tatli M, Satici O, Kanpolat Y, Sindou M：Various surgical modalities for trigeminal neuralgia：literature study of respective long-term outcomes. Acta Neurochir (Wien) 150：243-255, 2008

15）Yaşargil MG, Abernathey CD, Sarioglu AÇ：Microneurosurgical treatment of intracranial dermoid and epidermoid tumors. Neurosurgery 24：561-567, 1989