慢性硬膜下血腫の成因に対する考察 : 経時的CT scanによる観察から

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A sequential study with computerized tomography (CT-scan) of two cases of chronic subdural hematoma was reported. Case 1 was a 67-year-old man who had a mild head injury. The initial CT-scan taken after 24 days of his injury showed bilateral frontotemporal extracerebral low density areas. This was diagnosed as subdural effusion because of its location, shape and the Hounsfield unit (11.0). He was admitted to our hospital with complaints of headache, nausea, vomiting and left hemiparesis. The CT-scan on the 41st day after his injury showed bilateral extracerebral high density areas instead of the previous low density. An operation was performed, and membranes of a subdural hematoma were observed. Case 2 was a 47-year-old man, who was admitted because of a mild head injury. The initial CT-scan (25 days) revealed bilateral extracerebral low density areas. This low density showed 11.7 in Hounsfield units suggesting subdural effusion. Follow-up CT-scans (after 76 days, 111 days, 113 days) demonstrated that chronic subdural hematoma had developed consequent on the post-traumatic subdural effusion. An operation disclosed a wellencapsulated hematoma. The conclusions obtained in this study were as follows ; (1 ) Development of the hematoma membrane does not start immediately after head injury. (2) Subdural effusion is formed a few days after head injury. (3) Then, neo-membrane begins to form during a certain period of subdural effusion. (4) Existence of the isolated cerebrospinal fluid between the dura and arachnoid membrane is the most important factor forming subdural hematoma. (5) Repeated hemorrhaging into the cavity from this neo-membrane may cause chronic subdural hematoma.
日本脳神経外科学会の論文
1980-08-15

慢性硬膜下血腫の成因に対する考察 : 経時的CT scanによる観察から

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