硬膜下膿瘍—自験9症例と文献的報告55症例の検討

Subdural Empyeina:Report of 9 Cases and Review of the Literature in Japan

Ⅰ．はじめに

　硬膜下膿瘍は，頭蓋内感染症のうち，髄膜炎，脳膿瘍に次ぐ位置を占め，その発生頻度は従来，脳膿瘍の1/4-1/5とされてきたが^5），脳膿瘍に比して最近その増加傾向が指摘され^3），報告例も増加してきている．

　本症に関しては，1974年，教室の大熊ら^9）が自験3例と本邦報告53例を集計して検討を行っているが，その後われわれの教室では6例の本症を経験し，その間CTの導入もあり，今回先の3例を含め自験9例を再検討し併せて文献的考察を加えたい．

Nine cases of subdural empyema experienced in our clinic during the period from 1958 to 1979 weer reported, and 64 cases, consisting of our cases and the cases in the domestic literature, were reviewed from the viewpoints of source of infection, symptoms, laboratory findings, localization of of empyema, organisms, treatment and prognosis.

In 6 (67%) of the 9 cases, infection was caused pantnasally. A close relationship was suggested between the location of subdural empyema and its source, thus it occurred in the frontal region most frequently, followed next by the temporal region in the reviewed cases.