老年期痴呆患者に生じた慢性硬膜下血腫の4例

Chronic Subdural Hematoma Occurring in Patients with Senile Dementia: Report of 4 cases

I．はじめに

　高齢者にみられる慢性硬膜下血腫（chronic subdural　hematoma，以下，CSHと略す）は，痴呆症状を呈することがあり，老年期痴呆と鑑別すべき重要な疾患のひとつであることは広く知られている^10）．また，既に痴呆状態の患者に，CSHを生じる例も，当然あり得るが，このような症例報告は非常に少ない^10,11）．われわれは，痴呆患者にCSHを生じた4症例を経験したので報告する．

Four cases are presented of male patients over 63 years of age. Preceding head injuries relating to chronic subdural hematoma (CSH) were noted in 2 patients. Suspected clinical signs of CSH were disturbance of consciousness and mono- or hemiparesis. Surgery, a burr-hole technique for external drainage, was per-formed in 2 patients, and nonsurgical treatment by in-travenous administration of glycerol was carried out in the remaining 2 patients. After the treatment, 3 patients returned to the previous demential state, and one who had been treated nonsurgically died of pneumonia.