両側性硬膜外血腫の自然発生をみたSystemic lupus erythematosusの1症例

A Case of Systemic Lupus Erythematosus Associated with Spontaneous Bilateral Epidural Hematomas

I．はじめに

　頭蓋内硬膜外血腫の自然発生は稀であり，その原因としてこれまでには硬膜の血管異常，出血傾向，副鼻腔炎，中耳炎などの波及があげられている^19）．今回われわれは，明らかな外傷機転がなく両側性に硬膜外血腫が自然発生し，その後に全身性エリテマトーデスsystemiclu-pus erythematosus（SLE）と確定診断された症例を経験した．

　SLEでは，精神神経症状が主要症状の1つであり，そのなかにはCTスキャンなどで，脳梗塞，脳内出血，くも膜下出血が確認された症例もみられるら^1,5,9,14）が，硬膜外血腫との合併は報告されておらず，また，本症例は両側性の硬膜外血腫の自然発生という点でも極めて稀と考えられたので，若干の考察を加えて報告する．

The authors reported a case of systemic lupus erythematosus (SLE) associated with bilateral epidural hematomas which had developed without any recent trauma.

A 34-year-old male suddenly suffered from a severe headache and vomited several times. He had no neurological deficits on admission, but CT scans of the head revealed abnormal high density areas over the parieto-occipital regions beneath the calvarium bilaterally. At the operation, fresh epidural clots were removed. There were neither evidence of trauma nor abnormal structures which might haveled to the development of the clots.