海馬回鈎嵌頓の1例

A CASE OF THE TRANSTENTORIAL UNCAL HERNIATION

　1930年および1936年Uincent等は小脳天幕切痕に側頭葉が嵌入する事の危険性を記載し，世の注目を引いた。其の後外国においては10数名の学者によつて本症が報告されているが本邦においては未だその発表を見ないようである。われわれは最近交通事故により頭部外傷を受けて中硬膜動脈が破綻し，硬膜下血腫を生じ，更に海馬回鈎嵌頓（incisural herniation, transtentorial uncal　herniation, tentorial pressure cone）を起した1例を経験したので報告する。

The late Clovis Uincent and his co-workers in 1930 and again 1936 called attention to the dangers inherent in the herniation of a part of one temporal lobe through the incisura of the tentorium cerebelli. Since then several authers had written on this matter in foreign countries, but not yet in our country.

On January 21, 1958, at 7.15 P.M., a farmer, aged 67, was riding on his bicycle along the pavement. Suddenly he was run down by a truck. Witnesses said that they found his lying on the ground as if dead. He was ad-mitted to the department of surgery, Gumma University at 7.50 P.M.

On exermination he was in deep coma. He lay supine, with legs extended and stiff. His arms were stiff, bowed and pronated: his wrists and metacarpophalangeal joints were flexed and his fingers extended. Left pupil was more widely dilated than right pupil, and did not react to bright light. His face had lost its expression and his mouth was open Breathing was light and rapid, 22 per min; the pulse-rate was 120, the blood-pressure over 250/110mmHg, and temperature 36.6℃.