特異な経過をとった橋出血の1手術例

A Case of Surgically cured Atypical Spontaneous Intrapontine Hematoma

Ⅰ．はじめに

　橋部の出血は，突然起こる昏睡，著明な呼吸障害，四肢麻痺，瞳孔異常を呈し，急速な経過をとり死に至る症例が多く，たとえ手術により血腫除去を行っても社会復帰できる症例は稀である．われわれは約6カ月に及ぶ慢性の経過をとり，橋部の腫瘍と鑑別が困難であった原発性橋出血の36歳の女性に，後頭下開頭により血腫の吸引を行い，多彩な神経症状をほぼ完治することができた．原発性橋出血にて，直接手術により治癒した症例は非常に稀であるので，文献的考察を加えて報告する．

A case of surgically cured spontaneous intrapotine hematoma was reported. This 36-year-old housewife was well until September 1975 when she suddenly developed hypoesthesia on her perioral region and her left hand. Over the next six months the patient continued to deteriorate. She was refered to neurosurgical ward of Hiroshima Prefectural Hospital on February 12, 1975.

Physical examination on admission revealed a well de-veloped alert woman complaining of slight headache. Her pupils were equal and reacted sluggishly. Her fundus showed no remarkable change.