高血圧性皮質下出血の臨床的検討—手術適応と長期予後について

Clinical Study of Hypertensive Subcortical Hemorrhage: Surgical indication and long-term, functional prognosis

I．はじめに

　最近，高血圧性被殻出血，視床出血，小脳出血では運動，知的機能予後の検討より外科的治療に疑義がもたれてきており，手術時期^7），手術方法についても議論が行われている^{2,8,9,12,14,19）}．しかし，高血圧性脳出血の10—15％を占める^4,16）皮質下出血は臨床経験上，機能予後が良好なことから，良い手術適応疾患として安易に外科的治療が行われてきており，機能予後を検討した上での手術適応について論じた報告はない，

　われわれは高血圧性皮質下出血の治療方針を導き出す目的で諸種臨床的因子，治療方法と退院時，長期機能予後について比較検討したので，その結果を報告するとともに手術適応について考察を加える．

There has been no report available for determining surgical indications in hypertensive subcortical hemor-rhage based on functional prognosis. The authors then studied the clinical results of hypertensive subcortical hemorrhage for evaluating the surgical indication in re-lation to functional prognosis.

Sixty-five patients with hypertensive subcortical hemorrhage diagnosed by CT scan who were hospital-ized to Matsue Red Cross Hospital from January 1980 up to December 1986 were studied. The 44 male and 21 female patients ranged in age from 37 to 86 years, and 38 of them were operated on.