―研究―外傷性くも膜下出血—16自験例とその臨床的検討

Traumatic Subarachnoid Hemorrhage: Clinical study of 16 cases

I．はじめに

　頭部外傷におけるCT所見の1つとして，外傷性くも膜下出血がみられるという報告は多い^{5,10,11,17,18）}．しかし，その発生機序，打撲部位との関係，予後などにまで言及したものは少なく，滝沢ら^15）の報告をみる程度である．今回われわれは，当院で経験した16症例をもとに外傷性くも膜下出血の臨床的検討を行ったところ，興味ある結果が得られたので，若干の文献的考察を加えて報告する．

Three hundred and eighty three cases with head injury were admitted to our hospital during period from March 1985 to October 1986. Among these cases, 16 (4.2%) had subarachnoid hemorrhage as revealed on computerized tomography (CT) scan ; other CT findings included epidural hematoma, subdural hematoma and/or cerebral contusion. Traumatic subarachnoid hemorrhage was most frequently found in the ambient and/or sylvian fissure. This suggests that head blow tended to product shear strain at the brainstem and in the direction from temporal tip to frontal base.