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Brain and Nerve No to Shinkei Volume 42, Issue 4 （April 1990）

Brain and Nerve 脳と神経 42巻4号（1990年4月発行）

Japanese English

原著

X線CTで診断されたくも膜下出血の出血源の検討 CLINICAL ANALYSIS OF ETIOLOGY OF SPONTANEOUS SUBARACHNOID HEMORRHAGE DIAGNOSED BY COMPUTED TOMOGRAPHY 小笠原邦昭 ¹ , 嘉山孝正 ^1,2 , 桜井芳明 ¹ , 新妻博 ¹ , 佐藤博雄 ¹ , 西野晶子 ¹ Kuniaki Ogasawara ¹ , Takamasa Kayama ^1,2 , Yoshiharu Sakurai ¹ , Hiroshi Niizuma ¹ , Hiroo Sato ¹ , Akiko Nishino ¹ ¹国立仙台病院脳卒中センター脳神経外科 ²東北大学医学部脳研脳神経外科 ¹Department of Neurosurgery, Stroke Center, Sendai National Hospital キーワード： subarachnoid hemorrhage , computed tomography , repeated angiography , cerebral aneurysms , unknown etiology Keyword: subarachnoid hemorrhage , computed tomography , repeated angiography , cerebral aneurysms , unknown etiology pp.399-404

発行日 1990年4月1日 Published Date 1990/4/1

DOI https://doi.org/10.11477/mf.1406900049

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Abstract 文献概要
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　CT scanにてくも膜下出血（SAH）と診断された575例について，2週間以上の間隔をおき複数同のfour vessel cerebral angiographyを行い，その出血源について検討した。初回脳血管写の結果57E例中25例（4.3％）が出血源不明であった。再血管写により，25例中8例（32％）に破裂脳動脈瘤が発見され，出血源が発見されず血液疾患等出血傾向を有する全身疾患も認められなかった症例は11例であった。このうち1例に再出血をきたし手術にて破裂脳動脈瘤を認めた。今回のわれわれの検討では，SAHの原因として従来の報告以上に破裂脳動脈瘤が94.8％と大多数を占め，出血源不明は1.7％と極めて低率であった。

In 575 cases with subarachnoid hemorrhage(SAH) diagnosed by computed tomography (CT) scan, four vessel cerebral angiography was per-formed several times at more than two-week inter-vals to investigate a source of the hemorrhage. The first four-vessel study on admission revealed 530 cases (92. 2%) of ruptured cerebral aneurysms, four (O. 7%) of ruptured arteriovenous malforma-tion, 25 (4. 3%) of unknown etiology. Repeated fourvessel study showed eight (32. 0%) aneurysms among 25 cases whose first studies were negative. Six of the eight cases had aneurysms in the vertebro-basilar system. In 11 cases, repeated four-vessel study failed to detect the hemorrhagic source ; and no generalized diseases were noted. One of them had recurrence of SAH 19 months after the onset of the initial one. The patient was underwent operation, which showed throm-bosed ruptured aneurysm. Our present investiga-tion demonstrated that ruptured aneurysm was responsible for 94. 8% of all 575 cases of SAH detected by CT sacns and 10 cases (1.7%) were diagnosed as cases of SAH of unknown etiology.