慢性硬膜下血腫発生に患者素因を考慮すべきことを示唆する1例をめぐつて

ON THE ONE CASE SUGGESTED THE IMPORTANCY OF THE DISPOSITION OF PATIENT FOR CHRONIC SUBDURAL HEMATOMA

I．いとぐち

　慢性硬膜下血腫の存在が1657年Wepfer^1）によつて初めて記載されて以来，その成因について諸家によつて多くの記載と討議がなされてきている。

　すなわち古くVirchow^2）（1850）にはじまる硬膜炎症説の考えによつて本症をpachymeningitis hemorrhagicainternaであるとする説，Trotter^3）（1914）にはじまる架橋静脈出血説，およびGardner^4）（1932），Voris^5）（1946）らの滲透圧説などである。しかしながら本症を動物において実験的に作製することが依然として不可能なため，これら成因についての諸説はいずれも推論の域を出ていなく，現在なお定説を確立するにいたつていない。

Numerous work has been done on the pathological etiolegy of the chronic subdural hematoma in the past 4 centuries and the true etiology of this he-matoma is still unclear. The etiology of this he-matoma did not explain even by the trauma theory. Many neurosurgeons who support the trauma theory are thinking that the minor head injury is great factor.

As the frequency of incidence of chronic subdural hematoma after minor head injury is not high, the authors are thinking that the disposition of patient should be considered as the common factor in all theory for pathological etiology.

The authors had reported the one case who was operated for chronic subdural hematoma on both sides in different occassion. The first operation had done in 1965 for the right chronic subdural hematoma one month after head injury and returned in pre-vious job. The second operation had carried out in 1967 for the left chronic subdural hematoma one month after different head trauma.

The fact that the patient had chronic subdural hematoma in each side after different had injury with interval of one year and two months suggested that the importancy of disposition of patient for chronic subdural hematoma.