小脳腫瘍症例の神経耳科学的考察

概要

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Neuro-otological examinations are important in the diagnosis of subtentorial lesions, because there are sometimes no other neurological signs in the early stage. Recent progress in radiologic imaging, especially MRI, has made it possible to diagnose intracranial lesions more easilly, but the functional assessment of abnormal lesions seen with MRI must be confirmed by neurological examinations.<BR>A cerebellar tumor was diagnosed by neuro-otological examinations and MRI in an 18-year-old male who complained of dizziness. He had received radiation therapy for a pineal tumor seven years earlier.<BR>Neuro-otological examinations such as positioning down beat nystagumus and dysmetria of eye movement suggested tumor in the cerebellum. After radiation therapy, the tumor signs disappeared on MRI, and the neuro-otological signs also improved. Two months later, neurological symptoms appeared again, and recurrence of the tumor was confirmed by MRI. As the tumor grew, the symptoms grew worse. Finally the tumor was removed surgically and identified as anaplastic astrocytoma.<BR>During the clinical course the severity of the neuro-otological findings corre-sponded to the extent of the tumor in the cerebellum. It was very helpful to follow this patient with neuro-otological examinations as well as radiologic imaging, to predict the prognosis.