術前小脳出血と診断した小脳膿瘍の1例

概要

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The differential diagnosis between cerebellar abscess and cerebellar hematoma is difficult and they may be incorrectly diagnosed. Reported is such a case of a 49-year-old male. The patient had sudden severe occipitalgia accompanied by vomiting and was admitted to a local clinic in April 1976. Following a lumbar puncture which displayed bloody cerebrospinal fluid, consciousness deteriorated to the semicomatose state. The next day, five days after the onset of symptoms, he was transferred to our hospital. Neurological examinations revealed cerebellar signs and neck stiffness without pyramidal tract signs. Leukocytosis with slight fever was also present. Vertebral angiography and conray ventriculography demonstrated a cerebellar mass in the rt. hemisphere. Suboccipital craniectomy was performed under a diagnosis of cerebellar hematoma. Contrary to the diagnosis, the operation revealed an abscess in the rt. cerebellar hemisphere.<BR>Differential diagnosis between the Type I intracerebellar hematoma by Freeman's classification and cerebellar abscess in the subacute stage is difficult, since the symptoms and clinical courses are similar. Therefore, it is essential to always keep in mind the possibilities of cerebellar abscess as well as tumors when dealing with such cases.
The Japanese Society on Surgery for Cerebral Strokeの論文