脳神経外科単科専門病院へ救急搬送されたBrugada症候群の1症例

A Case of Brugada Syndrome Presenting with Syncope Transferred by Ambulance to a Neurosurgical Hospital

Ⅰ．はじめに

　今回われわれは，失神後の頭部打撲のため脳神経外科専門病院へ救急搬送されたBrugada症候群の1例を経験したので報告する．Brugada症候群は突然死の原因疾患として重要であるばかりでなく，不整脈以外の特異的症状がなく見逃される可能性があるため注意が必要である．

　Brugada syndrome is a known cause of sudden death. We report a case of Brugada syndrome who was transferred by ambulance to our neurosurgical hospital.

　An 18-year-old male suddenly lost consciousness and collapsed at his home. His mother urgently called for an ambulance because there was atypical absence of consciousness for several minutes. Because the Japan Coma Scale (JCS) and the consciousness level was about 10 on arrival by ambulance, the emergency services suspected brain concussion, so transported him to our neurosurgical hospital. However, the JCS reached a level of 1 in the emergency room. Both skull X-P and a brain CT scan were performed but no abnormalities were observed, such as bone fracture or hematoma camed by cerebral contusion of the skull. We recognized a saddle-back ST elevation in the V3 portion and an atypical corved ST elevation in the V1-V2 portion based on the findings of electrocardiograms. As a result of the above findings, we suspected that the patient may have Brugada syndrome and the patient was therefore hospitalized and carefully followed up.

　We finally diagnosed the patient to have Brugada syndrome after consulting with a circulatory organ internal medicine specialist during the patient's hospitalization. Since,Brugada syndrome is a disease that may result in sudden death,further steps,such as an ICD (implantable cardioverter defibrillator) are thus considered to be necessary in this case.