Neurologia medico-chirurgica
Online ISSN : 1349-8029
Print ISSN : 0470-8105
ISSN-L : 0470-8105
V-Pシャント手術が奏効した良性頭蓋内圧充進症の1例
宗本 滋石黒 修三木村 明北林 正宏石井 久雅若松 弘一大日方 千春東馬 康郎
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1988 年 28 巻 3 号 p. 288-292

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A 59-year-old woman complained of headaches and vomiting. On admission, neurological examination revealed bilateral choked disc and tendon hyper-reflexia. Lumbar puncture showed a high opening cerebrospinal fluid (CSF) pressure (195 mmH2O) ; however, protein and sugar levels were normal. The CSF was clear and watery. Computed tomography showed that the bilateral white matter was of low density and the ventricles were compressed bilaterally. Intracranial pressure (ICP), measured continuously by means of a ventricular tube, ranged from 20 to 40 mmHg. The ICP record showed typical A waves and, when an A wave was observed, the patient simultaneously lost consciousness. From these data, the diagnosis of benign intracranial hypertension was established. Intravenous glycerol administration during ICP recording produced only a temporary decrease in ICP. Ventricular external drainage, however, was continuously effective. After a ventriculoperitoneal shunt had been emplaced, the patient recovered. In this case, continuous ICP recording was very useful in both the diagnosis of benign intracranial hypertension and evaluation of its treatment. Shunting is an effective treatment for this disease.
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