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Ⅰ.はじめに
脳動脈瘤の破裂により急性硬膜下血腫を来すことは,0.5〜7.9%に認められるとされている2-6,17,19,21).しかし,これらのうち,初回頭部CTにてくも膜下出血を伴わない症例は,文献を渉猟した限りでは本例を含めて18例と,比較的稀であった1,6-13,16,18,20,22).今回,われわれは頭部CT上明らかなくも膜下出血を認めず,純粋に急性硬膜下血腫のみで発症したと考えられる破裂脳動脈瘤の1例を経験し,一期的に血腫除去,並びに脳動脈瘤根治術を施行し,良好な経過を得ることができたので,若干の文献的考察を加えて報告する.
The incidence of acute subdural hematoma (SDH) due to a ruptured intracranial aneurysm varies from 0.5% to 7.9% of all intracranial aneurysms. Pure acute SDH without subarachnoid hemorrhage (SAH) is rare. According to the literature, only 18 cases (including our case) of pure acute SDH identified by CT scan have been reported. Here we report a case of an internal carotid-posterior communicating artery (IC-PC) aneurysm presenting pure acute SDH identified by CT. We summarize the 18 reported cases. A 55-year-old female experienced severe headache on October 9, 1999, which did not improve after medication.
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