内容に出血を認めた脳膿瘍の1例

A Case of Hemorrhage into a Brain Abscess

I．はじめに

　脳膿瘍はCTスキャン上ring enhancementを示し，悪性神経膠芽腫，転移性脳腫瘍などの脳腫瘍や，脳血管障害との鑑別が重要である．そして，ring enhancement内に高吸収域を認めた場合は，まず腫瘍内出血を考えるのが妥当と思われる．今回われわれは臨床経過に炎症を思わせる所見が少なく，出血傾向も認められなかったため，腫瘍内出血との鑑別が困難であった脳膿瘍内出血の1例を経験した．このような症例^1）は極めて稀であるので，腫瘍内出血との鑑別点，および出血の機序につき若干の考察を加え報告する．

A rare case of hemorrhage into a brain abscess in a 23-year-old man is reported.

The patient complained of headache and low-grade fever on February 26, 1986. Two days later, he de-veloped right hemiparesis and right hemisensory dis-turbance with mild consciousness disturbance and was admitted to a local hospital. Seven days after the onset, he suddenly became semicomatose, developed anisocor-is and was consequently transferred to the University Hospital.

On admission, his temperature was 37.5℃ and neuro-logical examination revealed semicoma, anisocoria and right hemiparesis without nuchal rigidity.