外側型脳内出血の局在部位と臨床症状:-超早期手術例の血腫腔造影による観察-
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Authors reviewed 32 cases of the lateral type of intracerebral hematoma which were operated on in peracutestage or within 7 hours after the attack and discussed the correlation between the site of hematoma and clinical symptoms. The method of Pantopaque radiography of the hematoma cavity was reported by us in the previous congress.<BR>Cases were classified in three groups by the site of hematoma relating to the internal capsule.<BR>1) Anterior type; Discussing on the horizontal section, hematoma was located in the anterior portion comparing to the anterior two third of the posterior limb of the internal capsule which was supposed to be the site of pyramidal tract. 6 of 32 cases belonged to this group. As the characteristic clinical symptoms all showed conjugate deviation and positive Babinski's sign before operation. Postoperatively, motor function was easily improved on gross strength but recovery of fine movement was difficult.<BR>2) Middle type; The hematoma located in the level of pyramidal tract or mostly in the posterior half of the putamen. 19 of 32 cases belonged to this group. The grade of recovery of hemiplegia depended on the distance between the site of hematoma and the internal capsule.<BR>3) Posterior type; Hematoma was located posteriorly in the posterior one third of the posterior limb of the internal capsule. 7 cases were this type with the characteristic sign of the severe sensory disturbance comparing to the motor function. Autotopagnosia, astereognosia and slight decrease of superficial sense were usually observed. Visual field defects were also frequently confirmed.
- The Japanese Society on Surgery for Cerebral Strokeの論文
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