小脳出血の2治験例
スポンサーリンク
概要
- 論文の詳細を見る
Case 1; A 57-year-old female, who had a hypertention in her history, has experienced a sudden severe headache followed by nausea and vomiting on Jan. 8th, '76. A bloody CSF was revealed on lumbar tap. 4 vessels-angiography on following days revealed no evidence of rupture of inntracranial aneurysms. On 14th day she was referred to us for further study. She was drowsy, but had no neuro-deficit except for moderate papilledema and mild muscular hypotonicity in her Rt. limbs. Cerebral angiography showed an advanced hydrocephalus and a posterior fossa mass lesion. Immediate ventricular drainage through Rt. frontal horn improved markedly her conscious level. On Jan. 29th a suboccipital craniectomy was carried out and ca. 20 gm hematoma was evacuated from paravermian portion of Rt. cerebellar hemisphere. She was discharged from our hospital on March 19th on her feet, with mild dizziness.<BR>Case 2; A 15-year-old boy was suffered on May 8th '76 from a sudden attack of severe headache followed by vomiting and gait ataxia, and was admitted to a local hospital, where a bloody CSF was proved on lumbar puncture. On 3rd day Pt. became progressively semicomatose. An acute hydrocephalus was revealed by angiography and a ventricular drainage was placed in Rt. frontal horn by one of authors.<BR>Pt. was transferred to us on the day with an endotracheal intubation, was stuporous, had anisocoria with retinal hemorrhage, conjugate eye deviation to Lt., Lt. facial palsy and mild Rt. hemiparesis. Ventriculogram with 1 ml Myodil suggested a mass lesion in Rt. cerebellar hemisphere. About 30 gm blood clot was evacuated from markedly swollen Rt. cerebellum on surgery. No vascular abnormality was detected under surgical microscope. A histology from hematoma wall was negative. Postoperative course was uneventful. On follow-up after 6 months Pt. has slight dizziness on acutely changing his head position and feels well in other. Neurology was negative, except for mild horizontal nystagmus to Lt.
- The Japanese Society on Surgery for Cerebral Strokeの論文