外傷性気脳症46例の検討 : 脳幹型と非脳幹型

概要

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In an analysis of 46 patients with traumatic pneumocephalus, the disorder was classified into two types - brainstem and non-brainstem - according to the location of intracranial air on the computed tomographic image. In the brainstem type (n=23), air could be seen around the brainstem, whereas in the non-brainstem type (n=23), air could be seen throughout the entire cranial cavity but not around the brainstem. The mortality in patients with the brainstem type was 57% and in those with the non-brainstem type, only 13%. All 23 patients with the brainstem type suffered from cerebral contusion, intracranial hematoma, and subdural hematoma. However, among those with the non-brainstem type, only 14 suffered from similar pathology. Twenty patients with brainstem type pneumocephalus were at consciousness levels II or III on admission, whereas only 10 patients with non-brainstem type had similarly impaired consciousness. The authors' evidence suggests that most cases of brainstem type pneumocephalus resulted from severer impact than that causing the non-brainstem type and that the brainstem type carries a higher mortality.
日本脳神経外科学会の論文
1987-10-15