硬膜外嚢水腫の一治験例

A CASE REPORT OF EPIDURAL HYDROMA

　交通事故による頭部外傷の激増傾向は最近特に注目を集めている所であり，特に硬膜外血腫，硬膜下血腫，神経症状を伴う陥凹骨折，脳内異物，頭蓋内動静脈瘤等の場合は適確な診断の下に適切な脳外科的処置が施こされるか否かによつて，予後が全く左右され，就中硬膜外血腫は経過が極めて速かで致命率も高く，時期を逸し，適切な手術が行なわれない場合には100％の致命率とされている^7）。

　最近我々は頭部外傷後，極めて長い平静期を経て後てんかん発作が発来して来院し，受傷後1年10ヵ月目に開頭手術が行なわれ，右頭頂部の巨大な硬膜外嚢水腫の摘出治験例を得たが，これは病歴及び組織所見から硬膜外血腫が嚢腫化し，而も嚢腫壁の著明な化骨を認め，慢性経過をとつたものであることが確認された極めて稀有な症例であると考えられる。

It is the epidural haemorrhage following head injury that is most acute and severe in neurosurgery. The mortality rate is nearly 100 per cent within a few days unless prompt and radical operation is performed.

Recently, however, we experienced a rare case of epidural hydroma of the right parie-tal region, which had a long lucid interval about two years after a head injury.

It is apparent tbat the patient in this case developed a posttraumatic epidural haemato-ma which progressed slowly and organized and finally became hydroma associated with bony metaplasia at the dural side. In additi-on, arachnoid and pia mater also cicatricified at the motor area of right cerebrum and which caused epileptic seizure.

The patient cured by means of extirpation of the hydroma (9cm×7cm×3cm).