脳室出血を伴なう脳溢血の一手術治験例

A SURGICALLY TREATED AND CURED CASE OF INTRACEREBRAL ASSOCIATED WITH VENTRICULAR HEMORRAGE CAUSED BY VASCULAR HYPERTENSION

はじめに

　周知のごとく老年病のうち高血圧ないし動脈硬化症によるいわゆる脳溢血の死亡率は極めて高い。このうち特に本症に続発する脳室出血は諸家の成績の示すように脳溢血死亡例中かなり高率に存在し，しかも発作後比較的短時間のうちにほとんど全例死亡している。このような脳室出血の成績は消極的な対症的療法ではその病態を改善せしめ得ないことを示し，一方これに対するなんらかの積極的治療の確立は緊急を要する重要な課題である。

　近年脳溢血に対する外科的治療は欧米においてMcKissock^1），　Lazorthes^2），　Davidoff^3）らにより試みられているが，本邦においてはほとんどなく，この分野における外科的治療の躍進が期待される。

A man, 42 years of age, with vascular hy-pertension for three years, was admitted on the second day after the attack of severe he-adache, unconsciousness, spastic right hemi-plegia and hemihypesthesia. The blood pressure was 260mm. systolic and 140mm. diastolic, puls rate 80 and body temperature 37.8℃

On the third day after admission, deep coma, hyperthermia and rigidity appeared more markedly. CSF was bloody and its pressure 750mm. of water. Burr hole was made on the right frontal region and the cannula was inserted in the lateral ventricle. Bloody fluid and clot were removed as much as possible, and ventricular drainage was performed.

The patient recovered slowly but steadily, and was discharged on foot with slight left hemiparesis six month after operation.