慢性硬膜下血腫の発生過程について : CTによる経時的観察から

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Ten cases of chronic subdural hematoma that were followed by a sequential study with computerized tomography (CT) from an early posttraumatic period to evolution of chronic subdural hematoma were reported. The initial head injuries were mild except for two cases. Case 2 had been suffering from thrombocyte-penic purpura, but the others has no specific past history. These cases were divided into two groups on the basis of the density of subdural collections on the initial CT. In four of these 10 cases, the initial CT showed thin subdural collections of high density suggesting acute subdural hematoma. Two weeks later, the density of subdural collections reduced, but their volumes increased. Clinical symptoms such as headache and disorientation occurred three or four weeks later. Preoperative CT showed similar huge subdural collections of low density and marked mass effect. These cases underwent surgery from 24 to 44 days after injury (average: 30 days), and development of neomembranes was confirmed. In the remaining six cases, the initial CT showed thin subdural collections of low density suggesting subdural hygroma. In five of the six cases, the density of the subdural collections was slightly higher than that of cerebrospinal fluid, and in one case, an area of spotted high density was shown. It was suggested that these were mixtures with blood. Follow-up CT scans revealed that the subdural collections increased in size but remained at a uniformly low density for the first month after the head injury, and then the increase in density occurred. Operations were performed 55 to 76 days after injury (average: 63 days), and operative findings were not different from those of common chronic subdural hematoma. From these investigations, it was suggested that there were two types of evolution of chronic subdural hematoma. One is the development from acute subdural hematomas, and the other from subdural hygromas. It is supposed that blood and cerebrospinal fluid are very important factors in the evolution of subdural collections into chronic subdural hematomas.
日本脳神経外科学会の論文
1982-04-15

慢性硬膜下血腫の発生過程について : CTによる経時的観察から

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