高血圧性小脳出血に対する定位的血腫溶解排除術の臨床効果

Stereotactic Evacuation of Hypertensive Cerebellar Hemorrhage Using Plasminogen Activator

I．はじめに

　高血圧性小脳出血に対する治療法としては，保存的療法や開頭血腫除去術，急性水頭症を伴う場合には，脳室ドレナージ術が行われており，その治療方針についてはなお議論の残るところである．

　最近，CTの発達に伴い，小脳出血の大きさ，脳幹部への圧迫の程度，第IV脳室の圧迫閉塞による水頭症の程度などがよくわかるようになってきた．

Treatment for hypertensive cerebellar hemorrhage still remains controversial as to whether direct surgical procedure is indicated or not. This is so even after the introduction of CT scan which easily demonstrates the location and size of the hematoma and the presence of hydrocephalus. In this paper, we present our experience of 20 patients with cerebellar hemorrhage treated by stereotactic evacuation using Komai's CT-stereotactic apparatus. All the patients had vertigo, cerebellar symptoms, dysfunction of brain stem or consciousness disturbance. The hematomas on CT scan were more than 28 mm in diameter.