脳内血腫を伴なった—Cerebral juxta-basal telangiectasiaの1例

A CASE OF CEREBRAL JUXTA-BASAL TELANGIECTASIA WITH INTRACEREBRAL HEMATOMA

はじめに

　脳底部に異常血管網を示す疾患については，現在まで多数の報告がある^2）。我々は最近，両側の異常血管網に合併した，脳内血腫の一例を経験した。手術により救命し，臨床症状の著しい改善を見たので報告し，若干の考察を加えることとする。

A case of cerebral juxta-basal telangiectasia with intracerebral hematoma was reported. A 34-year-old man suddenly complained of severe headache, vomiting and motor weakness on his left side on April 9th, 1970. The next morning, hemiplegia developed and he was admitted to a hospital, where lumber puncture was done ; pressure 360 mmH₂O and bloody. Right carotid angiography revealed vascular network at the base of the brain.

On April 17th, 1970, he was transferred to the Tokyo Metropolitan Police Hospital.

On admission, he was much excited and disori-ented. There was hemiplegia and hemihypesthesia on the left. Four vessel study revealed bilateral cerebral juxta-basal telangiectasia with intracerebral hematoma in the right deep temporal region.

On April 22nd, right fronto-temporal craniotomy was performed and intracerebral hematoma of 50 gm dark blood was removed. Angioma or vascular malformation was not found around the hematoma. Evacuation of the hamatoma and decompression was done. Post-operative course was uneventful. Two weeks later, he could elevate his left leg and arm, and one month later, he could walk by him-self, and was discharged.

Four month later, he was admitted again for cranioplasty, and 4 vessel study was performed.

This time, the vascular network from carotid arteries diminished. On the contrary retrograde filling from the vertebro-basilar system via rami splenii developed. Some consideration was made on the pathogenesis. The possibility of forming intracerbral hematoma was stressed from therapeutic point of view.