半球間裂部硬膜下膿瘍

An Interhemispheric Subdural Abscess

Ⅰ．はじめに

　頭蓋内硬膜下膿瘍は，頻度は脳内膿瘍より多くはないが，経過が迅速且より重篤で，緊急の手術的治療を必要とすることが多い．硬膜下膿瘍の中でも，殊に頭蓋内他部硬膜下膿瘍を合併しない純粋の半球間裂部又は傍大脳鎌部単独膿瘍の報告は，本邦ではまだ殆どなく，このものは通常の半球外側面硬膜下膿瘍と診断及治療上異る点があり，特に検討を要すると考えられた．

A subdural abscess which is confined to the interhemispheric space alone, which does not extend over the convexity, is rare. This is a specific form and is a complication of a common intracranial subdural abscess.

It is of great practical importance to determins this uncommon location, and cerebral angiography is most useful. Multiple trephinations or craniotomy for exploration and evacuation must be performed near the midline.

A 20 year old female was in a comatose state on admission. There was a flaccid paralysis of the right lower extremity and a dilated left pupil.