破裂脳動脈瘤のCT—初回破裂発作と再破裂発作

Computed Tomography in Ruptured Intracranial Aneurysm: A comparative study between initial bleeding and rebleeding

I．はじめに

　破裂脳動脈瘤の初回破裂発作と再破裂発作ではその手術適応や手術のtimingを決定する上で微妙な差があり，さらに再破裂発作では，初同破裂発作より症状が重篤になることが知られている．したがって，再破裂発作後の手術適応，手術時期，手術法を決定するためには，初回破裂発作時と再破裂発作時の種々の病態の相違を明らかにする必要がある．

　今回われわれは過去2年間に経験した120例の破裂脳動脈瘤症例中，初回破裂症例71例，再破裂症例49例について，CT scanを用い比較検討を行い，その映像の相違について検討を行った．

The differences between initial bleeding and re-bleeding due to ruptured intracranial aneurysm wasinvestigated by CT.

The study included 120 cases of ruptured cerebralaneurysm; 71 cases had only one bleeding and 49cases had rebleeding. All the cases underwent CTexaminations within 2 weeks following bleeding.

Subarachnoid hemorrhages were classified into threegroups according to the CT findings: Diffuse hightype-high density areas in the entire basal cistern;Localized high type-high density area in a restrictedpart of the basal cistern; and Iso or Low type-nohigh density areas in the basal cistern.