頭蓋内出血を初発症状とした脳腫瘍症例

A CASE OF "SPONTANEOUS" INTRACEREBRAL HE MATOMA SECONDARY TO OLIGODENDROGLIOMA

はじめに

　脳腫瘍から種々の頭蓋内出血が起ることは良く知られている。しかし臨床的に頭蓋内出血を初発症状としたという脳腫瘍症例の報告はそれ程多くはない^{2）10）16）}。

　筆者等は最近いわゆる特発性脳内血腫と考えられた14歳の女子に脳血管撮影を施行したところ，左側頭葉内space taking lesionの所見とともに造影剤のもれ（ext—ravasatlon）を認めた。ただちに緊急開頭を行ない血腫除去および出血血管の処置を行なつたが術中には出血原因は判明せず，原因探究の目的で血腫壁から切除した標本が後に組織学的にoligodendrogliomaと判定された。

A case of "Spontaneous" intracerebral hematoma secondary to oligodendroglioma is described.

In the same case angiography showed a collec-tion of contrast medium which was apparently extravasated. It is realized that angiography is potentially a hazaudous procedure and is suggested that angiography should be done in such institutes or conditions as to be able to provide definitive treatment whenever necessary especially in patients with suspected interacranial vascular accidents.

It is never to say that the origin of the hemor-rhage must always be searched for during operation.

If the etiology of hematoma could not be obta-ined even after the most careful observations ofhematoma wall and its surroundings, pieces ofbrain tissue should be removed in order to facilitate ahistologic diagnosis.