器質化した慢性硬膜下血腫に対する開頭術

Craniotomy for Organized Subdural Hematoma

Ⅰ．はじめに

　慢性硬膜下血腫は通常，1度の穿頭血腫除去術で治癒するが，器質化血腫のため穿頭術では血腫除去が困難な例や，再発を繰り返す例があり治療に難渋することがある．今回，穿頭術では治療困難な慢性硬膜下血腫に対して，開頭術を行うことにより根治せしめることが可能であった症例を経験したので，手術適応や手術方法について考察を加え報告する．

We reported 3 cases of organized chronic subdural hematoma (CSDH),which required radical treatment by craniotomy. All patients were in the 70s (male,two; female,one).Two cases had previously received craniotomy and neck clipping for intracranial aneurysm. All of them received trephine evacuation of hematoma more than two times,although the hematoma was not removed due to organization. Because of this,we performed craniotomy and removal of the hematoma with its thick outer membrane. In order to obliterate the subdural space completely,we stripped the dura mater from the skull and attached it to the inner membrane with fibrine glue. After a period of more than two years of followed-up,no recurrences had been discovered.