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I.はじめに
急性期頭部外傷例の診断にCTが有用であることは既に周知のことである.しかしわれわれは,入院時CT像からは予測しえない経過をとった3剖検例を経験した.これらはそれぞれ,硬膜外血腫術後に発生した外傷性脳内血腫,小脳挫傷,大脳縦裂硬膜下血腫という比較的特異なものであった.そこで,各病態に関し文献的考察を加え,ここに報告する.
We experienced three autopsy cases with acute head injury in which developing fatal intracranial lesions could not be predicted by the initial admission CT scans. We studied these cases in detail.
Case 1. A 52-year-old man fell down from a bicycle and had a bruise in the right frontal region. He was stuporous and delirious 1.5 hours after the injury. Admission CT scan disclosed a large extradural hematoma over the right frontoparietal convexity and a small hemorrhagic contusion in the right frontal lobe (Fig. 1). In spite of removal of the hematoma and external decompression, the level of consciousness deteriorated progressively to coma.
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