慢性硬膜下血腫例における運動麻痺出現のpositron emission topography（PET）による解析

Analysis using Positron Emission Topography (PET) in Hemiparetic Patients with Chronic Subdural Hematoma

Ⅰ．はじめに

　一般的に言えば，慢性硬膜下血腫は穿頭術で血腫吸引や血腫腔の洗浄を行うことで神経症状が回復する転帰良好な疾患である．しかし，その成因や病態については現在も不明な点が多い．これまでに慢性硬膜下血腫の症例について脳血流を調べた報告はされているが^{1-3,5,6,9-12）}，運動麻痺などの神経症状が出現する原因は，脳血流の低下か否かは分かっていない．今回われわれは，慢性硬膜下血腫の脳循環代謝を術前，術後に経時的にPETを用いて測定し，運動麻痺の出現について検討したので報告する．

Chronic subdural hematoma (CSH) is a disease caused by minor head trauma and can be cured by surgical treat-ment. It remains unclear why CSH can cause neurologic dysfunction such as hemiparesis, although some reports de-scribe the contribution of impaired cerebral blood flow (CBF) and oxygen metabolism of patients with CSH. We studied five hemiparetic patients with unilateral CSH using positron emission tomography (PET). Before the opera-tion, both the regional CBF (rCBF) and regional cerebral metabolic rate of oxygen (rCMRO2) were observed to have decreased slightly in the motor cortex and the lentiform nucleus on the bilateral side.