急性特発性硬膜下血腫の2例

ACUTE SPONTANEOUS SUBDURAL HEMATOMA REPORT OF TWO CASES

Ｉ．はじめに

　Subdural hematomaの発生にはacute subduralhematomaの場合は勿論，chronic subdural hematomaの場合にも外傷の既往が重要視されている。しかし一方外傷とは全く関係なく卒中様発作で発症するacutespontaneous subdural hematomaに関してもその数は少いが報告されており，いわゆる他の脳卒中群との鑑別が重要視される。

　我々も外傷の既往はなく卒中様の発作で発症したactue spontaneous subdural hematomaの2手術例を経験し治療退院せしめえたので報告し，若干の文献的考察を加える。

Acute spontaneous subdural hematoma is not a common disease and only 11 cases could be found in the literatures as far as we reviewed. The symptom of the onset resembles the ones of other intracranial hemorrhages, so it is difficult to dif-fercentiate from the other cerebrovascular accident only symptomatologically. However, if it is treated adequately, its prognosis is good. On this report, two cases of this disease were presented with special reference to the ever reported cases.

Case 1. A fifty-nine year old man was admitted to our clinic in drowsy state on May, 9, 1968. Severe headache suddenly developed without any head injury 13 days before. The blood pressure was 192-100 mmHg at the time of onset and the liquor was watery clear with the normal pressure. He had no head injury in his past history. The left subdural hematoma was diagnosed by the carotid angiography. On surgery, there was no capsule formation as seen in cases of chronic sub-dural hematoma and its bleeding point could not be found. Total evacuation of the hematoma was performed with good results.

Case 2. A sixty year old man was also admitted to our clinic in derilious state on May, 15, 1968. He had complained of severe frontalgia with tem-poral unconsciousness 15 days before. He had no head injury. The right subdural hematoma could be found on cerebral angiography. The hematoma was successfully evacuated but we could not find the bleeding point at the time of surgery.