慢性硬膜下血腫―その再発および予防に関して

Chronic Subdural Hematoma:Recurrence and Prevention

はじめに

　慢性硬膜下血腫は脳神経外科医が日常診療で最も多く遭遇する疾患の1つである。通常，適切な診断と外科的治療によって良好な予後が得られる。しかし，術後の再発は，その確率が5～30％程度と報告され^1－11），さまざまな再発予防の取り組みにもかかわらず，未解決の問題として残されている。本稿では慢性硬膜下血腫の再発およびその予防に焦点を絞り概説する。

Abstract

　Chronic subdural hematoma is one of the most common disorders observed in routine neurosurgical care.　In the vast majority of cases, this disorder is treated by surgical evacuation, which usually yields a good prognosis.　However, the recurrence rates after this initial procedure range from approximately 5% to 30%.　In this study, we focused on the recurrence rate of chronic subdural hematoma and its prevention.　We reviewed the risk factors for recurrence, surgical procedures used, perioperative management, timing of operation, and medical treatment.

(Received: April 30,2010,Accepted: October 4,2010)