時期を異にして発症した両側高血圧性脳内出血の2例:-1側保存療法, 対側血腫摘出術後の病理比較-

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Case 1: T. M., A 38-year-old male presented with sudden onset of left hemiparesis. An angiographic diagnosis was a left basal ganglionic hemorrhage. He was treated conservatively and improved to be able to walk. Four months after, the patient presented with sudden onset of right hemiparesis and loss of consciousness. Four days after the second attack, about 60g of left ganglionic hematoma was evacuated. But he remained unresponsive and died six months after the operation. A postmortem brain cutting revealed a large cavity at the conservatively treated side which commumicated with the lateral ventricle and remarkable brain atrophy of that side. But there were no cavity and atrophic findings at the operative side.<BR>Case 2: Y. I., A 65- year-old male presented with sudden onset of right hemiparesis. Lumbar puncture showed bloody cerebro-spinal fluid. He was treated conservatively and improved to be able to walk. Sixteen years after the patient presented with sudden onset of left hemiparesis and loss of consciousness. Five hours after the second attack, about 20g of right ganglionic hematoma was evacuated. Left hemiparesis improved but pseud-bulbar palsy remained. PEG at four months after the operation showed a large cavity and remarkable brain atrophy of conservatively treated side, but there was no atrophic sign at the operative side.<BR>A hypertensive basal ganglionic hematoma should be evacuated before irreversible changes due to edema occur.
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時期を異にして発症した両側高血圧性脳内出血の2例:-1側保存療法, 対側血腫摘出術後の病理比較-

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