慢性硬膜下血腫における血腫被膜からの出血の意義

Hemorrhage from the Outer Membrane of Chronic Subdural Hematoma

　慢性硬膜下血腫は軽微な外傷後に数週，あるいは数カ月の無症状の期間を経て発症し，また，折々症状の消長がみられる．その病態生理に関しては未だ充分な解決が得られていない．血腫の増大に関し，Gardner^1）　ZollingerとGross^8）らは滲透圧の面から説明しようとした．

　しかし，血腫被膜が完成され，それが半透膜として作用したとしても，内外の滲透圧は比較的短時間に平衡値に達し，それのみでは血腫の増大を説明しえない．われわれは慢性硬膜下血腫症例について，血腫被膜，ならびに血腫内容を検索し，血腫の本態を究明した．

In this investigation, the contents of chronic subdural hematoma were studied biophysically.

The results are as follows: (1) Smears, made from content of subdural hematoma, revealed many red cell corpscles without deformity. This suggests that constant and fresh bleeding occured into the subdural hematoma in spite of chronic disease. When injecting ⁵¹Cr-labeled red cell corpscles intravenously in 5 cases, RI-activities of serum and hematoma content were counted by scintillation counter and amount of hemorrhage was calculated.