高血圧性小脳出血の臨床的検討—手術適応と血腫量測定について

Clinical Study of Hypertensive Cerebellar Hemorrhage: Surgical indication and measurement of volume of hematoma

I．はじめに

　高血性小脳出血はCT scanの導入によって診断が極めて容易となり，血腫の大きさ，局在，脳室穿破，水頭症の有無等が正確に把握され，その結果，手術適応は血腫径（血腫径3cm以上の症例が手術の対象）を主体にして決定される様になった^4,5,17）．しかし最近．多数の臨床経験の積み重ねにより，血腫径3cm以上の症例でも保存的治療で予後の良好な症例が散見される様になり，この手術適応基準に疑義が持たれてきている^1,8）．

　われわれは高血圧性小脳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，手術適応基準としての血腫体積測定の意義について考察を加えたので報告する．

There have been a few reports available for deter-mining surgical indications in hypertensive cerebellar hemorrhage based on volume of hematoma on com-puterized tomography (CT). The authors then studied the clinical results of hypertensive cerebellar hemor-rhage, and the surgical indication based on clinical find-ings and volume of hematoma on CT scan was consi-dered.

Forty-five patients with hypertensive cerebellar hemorrhage diagnosed by CT scan who were hospital-ized to Matsue Red Cross Hospital from January 1980 up to December 1986 were studied.