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A CASE FAVORABLY PROGRESSED AFTER OPERATION FOR HYPERTENSIVE INTRACEREBRAL HEMORRHAGE SHOWED EXTRAVASATION ON ANGIOGRAM OCCURRED IN CHRONIC ALCOHOLISM pp.303-307
Published Date 1985/3/1
DOI https://doi.org/10.11477/mf.1406205484
  • Abstract
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It is said that the prognosis is generally unfa-vorable in patients with hypertensive intracerebral hemorrhage showed extravasation on angiogram. Recently, we experienced a case whose prognosis was evenful after the removal of hematoma. So we reported this case and discussed between chronic alcoholism and intracerebral hemorrhage accompanied with extravasation on angiogram in this paper.

A 59-year-old male was transferred to our emer-gency center because of right hemiplegia and mild clouding of consciousness at around nine in the evening on December 12, 1983. At the time of admission, his neurological state was classified into grade III, exhibiting the right putaminal hemorrhage and pyramidal destruction type of hematoma by CT scan with 58 ml of hematoma volume. The right carotid angiography was im-mediately performed and confirmed the hematoma being of lateral type. At that time, extravasationproximal to the lateral lenticulostriate artery was noted. Repeated CT scan revealed the enlarged hematoma (105 ml) accompanying with ventricular hemorrhage. At the completion of these exami-nations, the neurological grade was III. The hematoma was surgically removed after 4 hours following the onset of cerebral hemorrhage. His postoperative course was very favorable. Although acute hydrocephalus appeared later on, it was cured by ventricular drainage. The patient become pos-sible to walk with a helper by 1 month after operation. CT scan obtained 1 month after ope-ration revealed a remarkable brain atrophy, which was probably derived from chronic alcoholism. It is seemed that the intracranial space caused by this brain atrophy may relieve the increased of intracranial pressure in the acute stage, which ultimately resulted in a controlled intracranial pressure required for the acute stage in the course of nature. Thus, even in such cases in danger as showing extravasation, a strict control of intra-cranial pressure followed by craniotomy, removal of hematoma and adequate treatment of hemor-rhagic source may lead to an increased number of patients to be saved.


Copyright © 1985, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 2185-405X 印刷版ISSN 0006-8969 医学書院

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