電動ノコギリによる開放性頭部外傷の1例

A Case of Open Head Injury Caused by Electric Saw

Ⅰ．はじめに

　建築用工具による頭部外傷は非常に稀である．日常診療において遭遇することは珍しいために，どのような治療方針で対処すべきか示されていない．このような建築用工具による外傷に関する報告例として，自動釘打機による穿通性頭部外傷は散見される^4,6,12)．しかし，わが国での自殺企図を除く，電動ノコギリによる頭部外傷症例の報告は渉猟できなかった．今回，われわれは電動ノコギリにより，脳挫傷を伴う開放性頭部外傷例を経験した．本症例に対して，受傷後早期に手術を施行し，感染を合併することなく救命し得たので報告する．

　A rare case of traumatic injury caused by an electric saw is herein described. A 75-year-old male patient was admitted to our hospital as an emergency patient. At the time of the patient's admission,he was fully conscious with no neurological deficits. Computed tomography revealed an intracerebral hematoma in the right frontal lobe,traumatic subarachnoid hemorrhage and pneumocephalus. Emergency surgery was performed at 4 hours 30 minutes after the injury. After a right frontal craniectomy,the intracerebral hematoma was completely evacuated. We applied sufficient debridement. The patient had neither intracranial infection nor vascular injury. We believe that the early operation for the sake of safety was therefore effective for this patient.