慢性期に穿頭術で軽快した外傷性急性大脳半球間裂血腫の1例

Acute Interhemispheric Subdural Hematoma: A case report with good result brought about by small craniotomy during the chronic stage

I．はじめに

　動脈瘤や動静脈奇形のような脳血管障害に由来する場合を除き，頭部外傷による大きな急性硬膜下血腫が主として大脳半球間裂に認められる例は一般に少ない^3-6）．われわれはこのような外傷性急性大脳半球間裂血腫に対し急性期には保存的療法を余儀なくされたが，発症1カ月後に局所麻酔下に血腫除去を行い残存症状の著しい改善が得られた症例を経験したので若干の文献的考察を加えて報告する．

A 88-year-old male slipped down and hit his head on the floor on the night of November 27, 1988. He was able to return to bed and fell asleep. Next morning, he noticed gait disturbance and was admitted to our clinic. Neurological examination revealed monoparesis (1/5) and hyperreflexia of the left lower extremity. Com-puted tomography (CT) demonstrated a semilunar high density area with the base toward the right side of the falx. General anesthesia for craniotomy was judged to he contra-indicated because serious ischemic heart dis-ease was also present.