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Neurological Surgery No Shinkei Geka Volume 19, Issue 4 （April 1991）

Neurological Surgery 脳神経外科 19巻4号（1991年4月発行）

Japanese English

症例

外傷性両側基底核出血の2例 Bilateral Traumatic Hemorrhage in the Basal Ganglia:Report of two cases 谷中清之 ¹ , 江頭泰平 ¹ , 牧豊 ¹ , 高野晋吾 ¹ , 岡崎匡雄 ¹ , 松丸祐司 ¹ , 亀崎高夫 ² , 小野幸雄 ² , 能勢忠男 ³ Kiyoyuki YANAKA ¹ , Taihei EGASHIRA ¹ , Yutaka MAKI ¹ , Shingo TAKANO ¹ , Masao OKAZAKI ¹ , Yuji MATSUMARU ¹ , Takao KAMEZAKI ² , Yukio ONO ² , Tadao NOSE ³ ¹北茨城市立総合病院脳外科 ²県西総合病院脳神経外科 ³筑波大学臨床医学系脳神経外科 ¹Department of Neurosurgery, Kitaibaraki-City General Hospital ²Department of Neurosurgery, Kensei General Hospital ³Department of Neurosurgery, Institute of Clinical Medicine, University of Tsukuba キーワード： Basal ganglia , Diffuse axonal injury , Head injury , Intracerebral hematoma , Shearing injury Keyword: Basal ganglia , Diffuse axonal injury , Head injury , Intracerebral hematoma , Shearing injury pp.369-373

発行日 1991年4月10日 Published Date 1991/4/10

DOI https://doi.org/10.11477/mf.1436900247

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Abstract 文献概要
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I．はじめに

　外傷性基底核出血は比較的希な病態とされている．近年その報告例は増加しつつあるが，両側性基底核出血例は未だ極めて希である．今回我々はその2症例を経験したが，これらの症例はその発生のメカニズムに関し，極めて重要な示唆に富むと思われたので報告する．

Abstract

Hematomas of the basal ganglia in head injury have long been recognized by pathologists with an interst in head injury but their mechanism has not been revealed clearly. We report two cases of bilateral traumatic he-morrhage in the basal ganglia.

Case ♯ 1, a 17-year-old male was admitted to our hospital immediately after a traffic accident. Neurologi-cal examination revealed that the patient was comatose and had right hemiparesis. CT scan showed bilateral hemorrhage of the basal ganglia and subarachnoid he-morrhage in the perimesencephalic cistern. MRI showed high signal intensity areas in the bilateral basal ganglia, perimesencephalic cistern, cerebral white mat-ter and corpus callosum. The patient was diagnosed as having diffuse axonal injury coinciding with bilateral hemorrhage of the basal ganglia. Stereotactic aspiration for the hematoma of the left basal ganglia was carried out.

Case ♯ 2, a 75-year-old male was admitted immedi-ately after falling from the roof of his house. Neurolo-gical examination revealed no neurological deficit ex-cept for headache and nausea. CT scan on the day of injury revealed no abnormality. But CT scan 12 hours following the injury showed bilateral hemorrhage of the basal ganglia. Blood pressure of the patient was within, normal range and he was diagnosed as having traumatic bilateral intracerebral hematoma. Conserva-tive treatment was carried out and the patient was dis-charged 7 days after injury with no neurological deficit. The mechanism of traumatic hemorrhage of the basal ganglia has not been clear. In case # 1, diffuse axonal injury (DAI) may have played an important role in the bilateral hemorrhage. But in case # 2, non-DAI factor such as vasoparalysis syndrome may have existed. The mechanism of bilateral traumatic hemorrhage of the basal ganglia is complicated. Therefore these caess must be classified as either DAI or non-DAI.