高血圧性橋出血に対するCT定位血腫除去術—保存的治療との比較検討

Stereotactic Aspiration for Hypertensive Pontine Hemorrhage: Comparative study with conservative therapy

I．はじめに

　橋出血の診断は，従来，神経放射線学的に困難であったが，CT scanの出現・発達により，血腫の部位・大きさ・伸展方向等が正確に描出されるようになり容易になった．また一方，CTの発達と共に，定位的血腫除去術が容易に，しかも安全に施行し得ることが明らかになっている．

　われわれは，最近，高血圧性橋出血に対しても機能予後の改善を期待して，CT定位血腫除去術を行っている．そこでこの度，高血圧性橋血に対するCT定位血腫除去術の治療効果並びに手術適応を検討するため，血腫除去術例と保存的治療例との転帰を比較検討したので報告する．

Recently, CT-guided stereotactic aspiration has been attempted as a useful method for hypertensive in-tracerebral hemorrhage.

Since the CT scanner was introduced in our clinic, we have experienced 55 cases with hypertensive pon-tine hemorrhage. We carried out stereotactic aspiration in nine cases consisting of four men and five women, ranging in age from 34 to 66 years. Operation was per-formed on between 4 and 22 clays after the hemorrhage (mean: 7.7 days). On the other hand, 46 cases were conservatively treated. They consisted of 31 men and 15 women, aged from 31 to 79 years, with a mean age of 55.5 years.