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Brain and Nerve No to Shinkei Volume 25, Issue 3 （March 1973）

Brain and Nerve 脳と神経 25巻3号（1973年3月発行）

Japanese English

研究

慢性硬膜下血腫の脳波—脳血管写との対比を中心に THE ELECTROENCEPHALOGRAM IN SUBDURAL HEMATOMA:WITH REFERENCE TO CEREBRAL ANGIOGRAPHY AND OTHER CLINICAL FINDINGS 島史雄 ¹ , 前山隆太郎 ¹ , 岳野圭明 ¹ , 永富裕文 ² , 西村謙一 ^3,4 , 松岡成明 ⁴ Fumio Shima ¹ , Ryutaro Maeyama ¹ , Yoshiaki Takeno ¹ , Hirobumi Nagatomi ² , Ken-ichi Nishimura ^3,4 , Shigeaki Matsuoka ⁴ ¹佐賀県立病院好生館脳神経外科 ²大分県立病院脳神経外科 ³九州労災病院脳神経外科 ⁴九州大学医学部脳神経病研究施設外科 ¹Dept. of Neurosurgery, Saga Prefectural Hospital ²Dept. of Neurosurgery, Ooita Prefectural Hospital ³Dept. of Neurosurgery, Kyushu Rohsai Hospital ⁴Dept. of Neurosurgery, Kyushu University Hospital pp.321-328

発行日 1973年3月1日 Published Date 1973/3/1

DOI https://doi.org/10.11477/mf.1406203291

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Abstract 文献概要
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緒言

　慢性硬膜下血腫の臨床症状は，多彩にして微妙であり，時としてその診断がはなはだ困難な症例も決してまれではない。本症が疑わるれ症例に，脳波のような簡易な検査で，血腫の有無や左右側を知ることができれば，大変有意義なことである。さらにその上に，脳波記録から，血腫の厚さやそれによる脳圧迫の様相をある程度推定することができるなら，またそれなりに深い問題である。

　本症の術前脳波については，すでに多数の報告があるが，血腫部位診断上の意義をめぐつて多少の混乱が見受けられる。これら報告の多くは，単に脳波所見の集積から診断学的価値を論じたものであるが，その所見は，血腫の大きさや発達速度，患者の年齢などによつてもずいぶん異なるはずであり，混乱の理由は，このような臨床的事実に基づく要因への考慮が少ないところにもあると思わるれ。

In 20 cases of unilateral chronic subdural he-matoma the EEG findings were reviewed in relation to the cerebral angiography and some other clinical findings. The results were as follows.

1) Decreased amplitude of alpha activity was found in cases where the hematoma developed rapidly after the neurological symptoms had appeared. But there was no relation found be-tween the thickness of the hematoma and the de-crease of the amplitude.

2) Increased amplitude of the alpha activity wasalways associated with a thick hematoma, which had developed slowly during a long clinical term.

3) Marked asymmetric slow waves on the side of the hematoma were seen in cases with a thick hematoma, which had developed rapidly after the manifestation of neurological symptoms.

4) Monorhythmic frontal delta activity was found in cases which in the angiogram showed a remark-able shift of the anterior cerebral artery.

5) Slow alpha activity due to the existence of a hematoma was found only in elderly patients.

As seen above, in cases of subdural hematoma, the EEG findings had some relation to the thick-ness of the hematoma and the shift of the anterior cerebral artery and also were depending consider-ablly on the development of the clinical course of the hematoma.

In two cases the EEG recordings showed no ab-normal findings, in spite of the fact that hemato-mas actually existed. It should be noted that these hematomas were not smaller in size than those of the other cases. This again indicates that in cases of subdural hematoma, the EEG recordings are not always reliable.