高血圧性脳出血非早期軽症例に対する手術

概要

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Indication for neurosurgical treament in the early stage of moderate cases of hypertensive intracerebral hemorrhage seems to be widely accepted. However, in delayed cases with negligible disturbance of consciousness and hemiparesis and/or mild deficit palliative treatment is still common. This paper reports our experience with final results of surgery performed on 14 cases of this kind, in which 15 or more days elapsed since the stroke and symptoms were stationary.<BR>Postoperative neurological improvement was closely followed in all 5 cases with slight disturbance of consciousness, in the 3 cases with choked disc, and in 2 cases with oculomotor palsy. There was improvement in 7 of 8 cases with aphasia, in 10 of 14 cases with hemiparesis and in 2 of 5 cases with paresthesia. There was no improvement in 3 cases with defect of visual field. There were no deaths due to the operation in these delayed mild cases. We feel that the intracranial operation in these delayed (more than 15 days for all patients) cases of hypertensive intracerebral hemorrhage motivated alleviation of the stationary symptoms, and that it was worthwhile for that reason.
The Japanese Society on Surgery for Cerebral Strokeの論文