クモ膜下腔拡大を伴う硬膜下液貯溜

概要

論文の詳細を見る
CT scans of 26 cases of subdural hematomas were carefully reviewed with particular emphasis on their densities. All the five cases of verified infantile chronic subdural hematoma, and four out of 15 cases of adult chronic subdural hematomas showed accumulations of CSF-dense fluid over the hemispheres, as well as in the cerebral sulci and cisterns, which were clearly demarcated from the overlying, rather high-dense, subdural hematomas. The accumulation over the hemisphere was thicker where the underlying brain was severely atrophied. One of these had been erroneously diagnosed as 'brain atrophy'. This and one adult case later progressed to a lentiform chronic subdural hematoma without CSF accumulation. Among six acute infantile subdural hematoma cases, three clinically mild cases showed accumulation of fluid in the sulci, fissures, and over the hemispheres, which gave the appearance of 'brain atrophy'. Among three cases of severe form acute subdural hematomas, one showed a localized accumulation of CSF-dense fluid underneath the clot and over the hemisphere with sulcal patterns. In two cases of adult subdural effusions, metrizamide CT cisternography was performed. In both cases the dye not only filled the widely open cistems and sulci, but also showed the existence of the subarachnoid space over the hemispheres and even beneath the subdural fluid space. From these observations it seemed logical that the subdural effusion (hematoma) was usually accompanied by enlargement of the subarachnoid spaces. In the acute phase, either primary subarachnoid hemorrhage or secondary bleeding from permeation of the subdural blood would cause blockage of the arachnoid villi, and the subsequent evolution of communicating hydrocephalus. In the chronic phase, however, hydrocephalus ex vacuo should play an important role, since the CSF accumulation appeared to have increased under decreased intracranial pressure with brain atrophy and/or enlargement of the calvarium, i.e., craniocerebral disproportion. Previous reports such as benign subdural collection of fluid, should be interpreted as the combination of subdural fluid with enlargementof the subarachnoid spaces. Similarly, in case termed benign enlargement of the subarachnoid spaces, benign communicating hydrocephalus, etc., the coexistence of subdural fluid must be considered and sought.
日本脳神経外科学会の論文
1982-09-15

クモ膜下腔拡大を伴う硬膜下液貯溜

スポンサーリンク

概要

著者

関連論文

スポンサーリンク