Shaken Baby Syndrome Manifesting as Chronic Subdural Hematoma : Importance of Single Photon Emission Computed Tomography for Treatment Indications : Case Report

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概要

• 論文の詳細を見る

• A boy with shaken baby syndrome first presented at age 3 months with acute subdural hematoma (SDH) and was treated by subdural tapping at a local hospital. Chronic SDH was identified at a rehabilitation center at age 19 months. The chronic SDH appeared to have developed within the preceding 16 months. His physical and mental development was already delayed. Magnetic resonance (MR) imaging revealed a 20-mm thick right chronic SDH with midline shift and small bilateral subdural effusions. The chronic SDH had compressed the right cerebral hemisphere. MR imaging also disclosed bilateral cerebral atrophy. ^<99m>Tc-ethylcysteinate dimer single photon emission computed tomography (SPECT) revealed decreased cerebral blood flow (CBF) in the non-hematoma hemisphere, although CBF is said to decrease on the chronic SDH side, especially if midline shift is present. Burr hole craniotomy with external drainage was performed, but the patient showed no change in CBF postoperatively, although the volume of hematoma decreased. The patient was clinically unchanged immediately after the operation. In this case, SPECT measurement of CBF was important in evaluating the pathophysiology of the delays in physical and mental growth. Atrophy of the bilateral hemispheres was the major mechanism in the decreased CBF, not the compression by chronic SDH. MR imaging and SPECT can determine the surgical indications for chronic SDH in patients with cortical atrophy.

• 日本脳神経外科学会の論文
• 2004-07-15

著者

• TSURUTA Wataro

  Department of Neurosurgery, Graduate School of Comprehensive Human Sciences, University of Tsukuba

• MATSUMURA Akira

  Department of Neurosurgery, Graduate School of Comprehensive Human Sciences, University of Tsukuba

• 松村 明

  秋本脳神経外科

• 松村 明

  筑波大学臨床医学系・脳神経外科

• Takeda Tohoru

  Department of Radiology, Institute of Clinical Medicine, University of Tsukuba

• YANAKA Kiyoyuki

  Department of Neurosurgery, Tsukuba University School of Medicine

• Matsumura A

  茨城西南医療センター病院 脳神経外科

• Tsuruta Wataro

  Departments Of Neurosurgery Institute Of Clinical Medicine University Of Tsukuba

• Tsuruta Wataro

  Department Of Neurological Surgery Institute Of Clinical Medicine University Of Tsukuba

• SATO Masayuki

  Department of Physics, Science University of Tokyo Kagurazaka

• Takeda Tohoru

  Departments Of Radiojogy Institute Of Clinical Medicine University Of Tsukuba

• Matsumura Akira

  Department Of Neurosurgery Graduate School Of Comprehensive Human Sciences University Of Tsukuba

• Matsumura Akira

  Departments Of Neurosurgery Institute Of Clinical Medicine University Of Tsukuba

• KUJIRAOKA Yuji

  Departments of Neurosurgery, Institute of Clinical Medicine, University of Tsukuba

• Yanaka Kiyoyuki

  Departments Of Neurosurgery Institute Of Clinical Medicine University Of Tsukuba

• Yanaka Kiyoyuki

  Department Of Neurological Surgery Institute Of Clinical Medicine University Of Tsukuba

• Kujiraoka Yuji

  Department Of Neurosurgery Ibaraki Prefectural Central Hospital

• Kujiraoka Yuji

  Departments Of Neurosurgery Institute Of Clinical Medicine University Of Tsukuba

• Takeda Tohoru

  Department Of Nuclear Medicine University Of Tsukuba

• Yanaka Kiyoyuki

  Neurosurgery Division Soujinkai Hospital Ibaraki;department Of Neurosurgery Institute Of Clinical Me

• Matsumura Akira

  Department Of Gastroenterology Dokkyo Medical University

• Sato Masayuki

  Department Of Neurosurgery Graduate School Of Comprehensive Human Sciences University Of Tsukuba

• Yanaka Kiyoyuki

  Neurosurgery Division Soujinkai Hospital Ibaraki;department Of Neurosurgery Institute Of Clinical Me

• Sato Masayuki

  Department Of Education For Children With Speech And Hearing Handicaps National Institute Of Special

• Sato Masayuki

  Departments Of Neurosurgery Institute Of Clinical Medicine University Of Tsukuba

• Sato Masayuki

  Department Of Biological And Chemical Engineering Gunma University

• Kujiraoka Yuji

  Department Of Neurosurgery Faculty Of Medicine University Of Tsukuba

• Matsumura Akira

  Department Of Forest Resources Science Shizuoka University

• MATSUMURA Akira

  Department of Electronic Science and Engineering, Faculty of Engineering, Kyoto University

• TSURUTA Wataro

  Department of Endovascular Neurosurgery, Toranomon Hospital

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