Neurological Surgery 脳神経外科43巻2号

2015年02月発行

症例

嫌気性菌Fusobacterium nucleatum感染による小脳膿瘍の1例

著者： 下川能史¹ 佐山徹郎¹ 芳賀整¹ 秋山智明¹ 森岡隆人¹

所属機関： ¹九州労災病院脳神経外科

ページ範囲：P.137 - P.142

Ⅰ．はじめに
　小脳膿瘍は，脳膿瘍の中でも3.8〜12%とテント上の脳膿瘍（大脳膿瘍）と比べて頻度は少ない^2,8,9,23)．また，その病態は大脳膿瘍と異なり，急速に閉塞性水頭症や小脳扁桃ヘルニアを来しやすく^8,9,22)，致死率も10〜15%と高いといわれてている^16,17)．治療に関しても，穿頭による持続排膿ドレナージが行いにくいなど，大脳膿瘍に対する外科的管理と異なる点が多い²⁴⁾．今回，嫌気性菌であるFusobacterium nucleatum感染による硬膜下膿瘍を伴った稀な小脳膿瘍に対し，2回の開頭手術による排膿に加えて，高圧酸素療法併用下の抗生剤治療を行い，良好な転帰を得た1例を報告する．

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