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Neurological Surgery No Shinkei Geka Volume 20, Issue 8 （August 1992）

Neurological Surgery 脳神経外科 20巻8号（1992年8月発行）

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CT scan上急速に自然消失した急性硬膜下血腫の2例—消失機序について Rapid Resolution of Acute Subdural Hematoma; Report of two cases 常喜達裕 ¹ , 橋本卓雄 ¹ , 赤地光司 ¹ , 朴正一 ¹ , 鈴木敬 ² , 中村紀夫 ¹ Tatsuhiro JOKI ¹ , Takuo HASHIMOTO ¹ , Kouji AKACHI ¹ , Masakazu BOKU ¹ , Kei SUZUKI ² , Norio NAKAMURA ¹ ¹東京慈恵会医科大学脳神経外科 ²東京慈恵会医科大学青戸病院脳神経外科 ¹Department of Neurosurgery, The Jikei University School of Medicine. ²Department of Neurosurgery, The Jikei University School of Medicine, Aoto Hospital. キーワード： Rapid resolution , Subdural hematoma , Acute diffuse brain swelling Keyword: Rapid resolution , Subdural hematoma , Acute diffuse brain swelling pp.915-919

発行日 1992年8月10日 Published Date 1992/8/10

DOI https://doi.org/10.11477/mf.1436900514

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Abstract 文献概要
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I．はじめに

　急性硬膜下血腫の自然経過は多彩であり，神経学的所見や頭部CT scanの所見からだけでは，予後を明確に予測することは困難である．

　今回われわれは，受傷直後に見られたmass effectを有する急性硬膜下血腫が，神経症状の急激な改善と共にCT scan上数時間以内に消失した症例を経験したので，若干の文献的考察を加えその臨床的意義について検討する．

We reported two cases of rapid resolution of acute subdural hematoma. Case 1, a 21-year-old female, sus-tained head trauma and became unconscious for about 15 min. Probably she was suffering from posttraumatic amnesia for about 1 day. On admission J.C.S and G.C.S were 20 and 9 (2 + 2 + 5) points, respectively. Neurolo-gical examination showed no abnormalities. An initial computed tomography (CT) scan taken 2 hours after the injury showed a high dense subdural hematoma on the left cerebral hemisphere and hemispheric swelling.She was conservatively treated. A follow up CT scan taken 8 hours after the injury disclosed rapid disappear-ance of the hematoma and cerebral swelling. Case 2a 23-year-old male, sustained head trauma and became unconscious for about 30 min. On admission J.C.S and G.C.S were 1 and 14 (4+4+6) points, respectively, and slight right hemiparesis was noted. An initial CT scan taken 2 hours after the injury showed subdural hemato-ma of the left cerebral hemisphere and hemispheric swelling. He was conservatively treated. A follow up CT scan taken 24 hours after the injury revealed almost complete disappearance of the subdural hemato-ma and cerebral swelling. It was suggested that the rapid resolution of acute subdural hematoma was attri-butable to redistribution due to decreace of ICP, and washing out by cerebrospinal fluid.