| Japanese |
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| Title | 小児脳幹部glioma症例における神経性高血圧の検討 |
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| Authors | 石栗仁*, 口脇博治*, 長坂昌登*, 小林達也*, 景山直樹** |
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| Organization | *名古屋大学脳神経外科, **岸和田市民病院脳神経外科 |
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| Journal | 循環制御 |
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| Volume | 8 |
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| Number | 4 |
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| Page | 521-528 |
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| Year/Month | 1987/ |
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| Article | 原著 |
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| Publisher | 日本循環制御医学会 |
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| Abstract | 中枢神経系疾患に合併する高血圧症の原因の一つに神経性高血圧がある. しかしその発生機序が充分に解明されていない為か, 実際の症例報告は極めて少ない. 我々は本態性高血圧の稀な小児例で, 血圧調節中枢の存在する脳幹部にgliomaを認めた8症例において, 神経性高血圧症例の有無を検討した. その結果, 8症例中2例で臨床経過の末期約1ケ月にわたる持続性高血圧の合併を認めた. 2例とも呼吸困難を契機として急激に血圧が上昇し, 意識状態の回復後も180／140mmHg（症例1）, 160／120mmHg（症例2）前後の高血圧状態が続いた. いずれも高血圧・腎疾患の既往はなく, 一般臨床検査上も急性糸球体腎炎などの明らかな高血圧の原因疾患を示唆する所見はなかった. CTscanでは橋（症例1）, 橋・左視床下部・視床・被殻（症例2）に腫瘍塊を認めた. 高血圧非合併例においてもautopsy所見上（5例）, 腫瘍の進展の程度は様々であり, 破壊性病変の大きさと高血圧発現との間には相関を見なかった. 病態の解明には, 特定な神経核の破壊と血圧上昇との関連性の検討が今後の課題であると考えられる. |
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| Practice | 基礎医学・関連科学 |
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| English |
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| Title | Neurogenic Hypertension in Pediatric Cases of Brain Stem Glioma |
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| Authors | Hitoshi Ishiguri*, Hiroji Kuchiwaki*, Masato Nagasaka*, Tatsuya Kobayashi*, Naoki Kageyama** |
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| Organization | *Department of Neurosurgery, School of Medicine, Nagoya University, **Department of Neurosurgery, Kishiwada Mumicipal Hosoptal |
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| Journal | Circulation Control |
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| Volume | 8 |
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| Number | 4 |
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| Page | 521-528 |
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| Year/Month | 1987/ |
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| Article | Original article |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | Any increase in excitation or reduction in the inhibition of the sympathetic vasomotor neurons, caused by disorders of the central nervous system, may theoretically produce an elevation of arterial blood pressure, termed neurogenic hypertension. Experimentally it has been produced in animals by surgical or chemical interventions at spcific nervous system sites, such as the nucleus of the solitary tract or some hypothalamic nuclei. However, clinical cases associated with neurogenic hypertension are rarely reported. In this retrospective study, we examined clinical cases in eight pediatric patients suffering from glioma located at the brain stem, where some neural center controlling arterial blood pressure is supposed to be present, and found two of them（seven−year−old boy：Case 1, and three−year−old girl：Case 2） to be associated with sustained hypertension （about 180−140 mmHg in Case 1, and 160／120mmHg in Case 2）. It appeared suddenly following respiratory distress, which seems to be related to acute dysfunction of the brain stem, and continued about one month in their terminal stage. They became drowsy, but neither stuporous or comatose for about one week after the onset of hypertension. They had no past history of hypertension or renal diseases. |
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| Practice | Basic medicine |
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