高血圧性脳出血に対する定位脳手術的血腫除去

Aspiration of Hypertensive Intracerebral Hematoma by Stereotactic Technique

I．はじめに

　高血圧性脳出血はCT scanの導入により，血腫の局在，進展方向，血腫量，脳室穿破の有無などが極めて正確に把握できるようになった．その治療において，われわれは主として視床や被殻に限局した出血，脳室穿破を伴う視床出血に対し，CT scanによる計測をもとに定位脳手術装置を用い，血腫の吸引除去を10例に試みた．この方法は手術侵襲が極めて小さく，かつ手術適応を吟味すれば有力な治療法の1つとなりうると考えられたので報告する．

Stereotactic aspiration of hypertensive intracerebral hematoma was performed in 10 patients. The patients selected for this operation had localized putaminal, thalamic hematoma and thalamic hemorrhage with ventricular penetration. The aspiration technique employed here could not remove the total hematoma, but did evacuate between half and two thirds of the volume estimated by CT scan. The target point determination was made by CT scan.

In 6 patients with localized hematomas, the operation was carried out between 18 and 60 days after the hemorrhage.