急性硬膜下血腫を来した髄膜腫の1手術例

An Operated Case of a Meningioma Causing Acute Subdural Hematoma

Ⅰ．はじめに

　髄膜腫は頭蓋内腫瘍の中では最も頻度の高い良性腫瘍である．脳内出血や腫瘍内出血を伴うことがしばしば報告されている^{1,3-13,15-18,20-23)}．一方，硬膜下血腫を合併した髄膜腫の症例はわれわれが渉猟し得た限り，これまで26例の報告があり，比較的稀である^{3,5,7,8,10,12,13,15-18,20-23)}．

　今回，われわれは急性硬膜下血腫を来した髄膜腫の1手術例を経験したので，若干の文献的考察を加え報告する．

　We report a rare case of a meningioma causing acute hematoma. A 67-year-old woman presented with sudden headache. No evidence of trauma was seen. CT demonstrated a subdural hematoma in the convexity of the fronto-temporal lobe. Magnetic resonance imaging showed marked signal heterogeneity in the convexity of the frontal lobe. One week later, the patient underwent hematoma evacuation and tumor resection including the attached dura mater. The histological diagnosis was meningothelial meningioma. The clot was connected directly to the tumor and the origin of the subdural hematoma was identified as the meningioma. Postoperative course was uneventful, and the headache improved. Meningiomas have a relatively benign course but rarely present with hemorrhage. Surgical exploration is the effective and recommended treatment.