視床および尾状核部出血例における両側側脳室ドレナージの妥当性

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The authors analized clinical courses of 35 patients with thalamic or caudate hemorrhage in our, clinic and showed some surgical procedures for those patients. Bilateral continuous drainages (CVD) were performed within 24 hours after onset in two patients, who were comatose on admission and diagnosed as thalamic hemorrhage with ventricular rupture. The prognosis of them was satisfactory. One of them was a 72-year-old female. This comatose patient showed bilateral pinpoint pupils and light reflex was sluggish. Hemiplegia on the right side was noted. Left carotid angiography revealed a large mass in the left thalamic region and bilateral CVD was done 16 hours after onset. Bloody cerebrospinal fluid (CSF) from the left lateral ventricle and almost clear CSF from the right lateral ventricle were obtained. The day after the operation she became somnolent. On the 10th hospital day, ventriculo-peritoneal shunt was done. Ventriculography was repeated via the ventricular tube and reduction of hematoma was verified. Four months after onset, she is alert and can walk with the aid of long leg brace, showing some impairment of ability to speak as well as to listen. She can eat by herself with her left hand. It is generally accepted that cerebral edema and acute hydrocephalus are induced by intracerebral hemorrhage and severity of it depends on the location, amount and extention of hematoma (with or without ventricular rupture). According to the experience mentioned above, we conclude that bilateral CVD is one of the most usefull methods of treatment and examination in some patients with thalamic or caudate hemorrhage with ventricular rupture.
The Japanese Society on Surgery for Cerebral Strokeの論文

視床および尾状核部出血例における両側側脳室ドレナージの妥当性

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