小児外傷性頭蓋内血腫—第2部：考按ならびに文献的考察

TRAUMATIC INTRACRANIAL HEMATOMA IN CHILDREN. PART II: DISCUSSION AND REVIEW OF LITERATURES

　前回，第1部（第25巻・第7号）において自験の小児外傷性頭蓋内血腫について述べたが，ここではこれらをもとに，血腫の種類別に考按し，あわせて文献的考察を加える。

In Part I, 53 cases of traumatic intracranial he-matomas admitted to Osaka Red Cross Hospitalwere presented.

In this part discussion and review of literatures were done.

Although all types of the hematomas were also noted in children, they were different from those of the adult in some aspects of mechanism of the injury, their development, and clinical pictures.

Epidural hematoma was not uncommon in child-ren. It could not be ruled out even when there was no fracture of the skull. Children, especially the young, might possess a large tolerance for the acute intracranial hypertension. When the com-pensatory mechanism for an increased intracranial pressure was broken down, however, the very rapid deterioration of the condition may ensue.

Acute subdural hematoma in children showed characteristic clinical pictures including head injury mechanism. In our series there were 3 cases of the school boy of chronic subdural hematoma. They revealed similar clinical course and symptoms with those of the adult. Among the authors there was no agreement of the opinion of the treatment of chronic subdural hematoma in infant.

The intracerebral hematoma was rare in children and developed with coup-injury mechanism.

Three cases of combined intracranial hematomas all died within 3 days and seemed to be too severe to be treated.