高度脳浮腫を呈した脳梗塞2例—出血性梗塞に関連して

Massive Brain Edema following Cerebral Infarction: Report of Two Cases

Ⅰ．はじめに

　脳梗塞による発作早期の死亡は脳出血にくらべるとはるかに少なく，緩慢な経過をとるのが通常である^13），そして脳梗塞による早期死亡は，両側性，広汎な梗塞や脳幹の梗塞によるものであり，脳梗塞に附随した致命的な脳浮腫の合併についてはあまり関心がもたれていない．

　著者らは発症後数日以内に高度の脳浮腫等を招来し，そのためにいずれも死亡の転帰をとった脳梗塞の2症例を経験したので，これらの症例を報告すると共に脳梗塞による高度脳浮腫の成因についての若干の考察を加えた．

Cerebral infarction occasionally gives rise to massive brain edema and fatal outcome in early period of onset. Two cases were reported in this paper, with special regards to the changes of intracranial pressure and angiographic findings.

The first case was a 60 year old man who had stroke onset on February 14, 1975. He was semicomatous and 1-hemiplegic. CAG at 15 hours after stroke disclosed complete occlusion at bifurcation of r-ICA, but no shift of midline structure, Spinal CSF was water-like clear and showed normal pressure during first 2 clays. In CAG on the 3rd day, vascular obstruction is remained at distal portion of r-MCA.