皮質下出血を繰り返したgliomaの1例

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This paper reports a rare case of glioma with repeated subcortical hemorrhages. A 38-year-old housewife was admitted to the Department of Neurosurgery because of sudden onset of frontal headache. On admission she presented with Gerstman's syndrome. Plain CT scan showed left parietooccipital subcortical hemorrhage and left carotid angiography revealed only avascular mass in the same area. CT scan repeated after 3 weeks showed disappearance of the high density area seen previously and no remarkable enhancement with contrast material. Under the diagnosis of idiopathic intracerebral hematoma, the patient was treated conservatively and discharged 4 weeks after the onset without neurological deficit. Two months after the first attack, the second episode occurred. This time CT scan showed several isolated high density areas with surrounding low density. Left carotid angiography also revealed a left parietoocipital mass and the posterior parietal artery terminating in on abnormal vascular stain. Removal of the hematoma and biopsy of the wall of the hematoma was carried out. The histopathological finding of the specimen was that of anaplastic astrocytoma. Three weeks postoperatively, she was transferred to another hospital for radiation therapy without neurological deficit. The incidence of tumor bleeding, as its initial clinical manifestation in particular, and mechanism of bleeding were discussed.
千葉大学の論文