高血圧性脳出血の早期手術例とExtravasationについて

SURGICAL TREATMENT OF HYPERTENSIVE INTRACEREBRAL HEMORRHAGE AT EARLY PHASE WITH CASES OF EXTRAVASATION

はじめに

　本邦においても高血圧性脳出血の手術適応については種々論議されており，手術成績も向上の途にあるが，最近の光野の集計^8）によると，脳卒中発作後24時間のうちに手術施行した症例の術後24時間以内の死亡率は50.9％で，手術無効例は38.2％と報告されており，早期手術の適応についてはなお検討を加える必要がある。最近，私達が発作後12時間以内に手術施行した症例を検討し，あわせて予後が不良とされるextravasation4例を救命し得たので文献的考察を加えて報告する。

It has been recently reported in Japan that post-operative mortaliry of hypertensive intracerebral hemorrhage was 50.9% within 24 hours after opera-tion. Surgical indication should be investigated more thoroughly at acute stage. Surgically treated 16 cases of hypertensive intracerebral hemorrhage in which operations were performed within 12 hours after onset were reported herein in detail with discussion concerning surgical indications at early phase.

Leakage of contrast medium were demonstrated in five out of twelve cases of hypertensive intra-cerebral hemorrhage, in which carotid serial angio-grapies were carried out within 5 hours after onset. Evacuation of hematoma was done in four out of five. All of them were saved by operation. There were no reports about live-saved cases of extrava-sation in the literature