躁うつ的状態を示した頭部外傷後遺症の1剖検例

AN AUTOPSY CASE OF HEAD INJURY WITH A MANIC-DEPRESSIVE STATES

I．はじめに

　頭部外傷後遺症による性格変化に関しては，すでに多数の報告がなされている。しかし，長期経過例の病理組織学的検討を行つた報告は少ない^3,5,13,21）。特に性格変化との関係についての検討は非常に少ない^5）。

　本例は受傷後，7年4カ月を経過し，性格変化として躁うつ的状態を示し，死後剖検により病理所見は，前頭葉眼窩面に限局した皮質挫傷巣のみであつた。そこで本稿では，性格変化と病理所見との関連性について考察を行つた。

M. M. a man aged 49. He suffered from a head injury at the aged of 41. At that time he lost consciousness for a few minutes and he was diagnosed as a consquassatio cerebri.

The sequelaes of his head injury were a change of character and a disturbance of autonomic nerve function. The changes of character were decrease of activity, lie-down for all day, decrease of speech and depressive mode, and occasionally he was ill-humored, restless and irritative. Periodically he became euphoric, talkative and childisch. He had a disturbance of autonomic nerve function which became worse in parallel to the depressive states.

We speculated that character changes, such as manic-depressive states and disturbance of autonomic nerve function were due to the bruising of the bilateral orbital surfaces of frontal lobes.