穿通性小脳外傷の1例

A Case of Penetrating Cerebellar Injury

Ⅰ．はじめに

　頭部外傷におけるテント上病変の臨床報告および実験報告は多くなされてきたが，テント下病変のそれははなはだ少ない．中村^9）の報告では頭部外傷1,300例中小脳症状のみを呈したものはわずかに5例（0.4％）であった．これは解剖学的に外傷を受けにくいという特殊性に基づいていると思われる．開放性後頭蓋窩損傷はさらに頻度が少ない．しかも生存例の報告はきわめて珍らしく，本邦では未だその報告をみない．われわれはこのような貴重な1例を経験し，Holmes^5）の報告以来発現機序が問題となっているskew deviationも観察したので若干の文献的考察を加えて報告する．

Reports of cerebellar injuries are less than these of cerebral injuries, because the cerebellum anatomically holds a specific position and many patients with cerebellar injuries die due to direct brain stem injuries or hemorrhage in posterior fossa. But if patients get over the acute stage in cerebellar injuries, their prognosis is extremely good. A 13-year-old boy fell in the grave and iron bar stuck into his neck. He was admitted to our survice for evaluation of disturbance of consciousness. At that time he was delirious and he had rt-facial palsy, skew deviation and curious spontaneous ocular movement but no paresis of extremities.