意識障害が昏妄以下の軽中等症例の手術適応について:-外側型出血に対する超早期手術の場合-
スポンサーリンク
概要
- 論文の詳細を見る
There has been much controversy on the surgical indication for mild or moderate cases of the lateral type of intracerebral hematoma, because the mortality of those cases are not too high even if treated conservatively. However, since the purpose of this sort of operation is for the functional improvement, we need to compare the long-term morbidity of both groups, the group of the conservative treatment and of the operative treatment. As the control group of the conservative treatment we quoted Kutsuzawa's data in which accurate topographic diagnosis of the hematoma has been done and the functional recovery has been analyzed in details after long-term observation.<BR>For the past 5 years, we operated 105 cases of the lateral type of intracerebral hematoma, in which 55 cases were operated within 7 hours after the apoplectic attack. In these cases of the early operation, there were 37 cases of the mild or moderate group of hematoma which were also followed up for more than a year. Those 37 cases were selected for comparison with Kutsuzawa's cases of the conservative treatment which was also 37 cases incidentally.<BR>The grades of the functional recovery were classified in 4 ADL grades in which ADL-1 means the group recovered to full activity, ADL-2 is the group with minimal disability for daily life, ADL-3 is the one with moderate disability or require help in daily life and ADL-4 is the one of severe disability or almost restricted in bed all day long.<BR>In our operated series, 21 cases recovered to the level of ADL-1, while 7 cases returned to ADL-1 in the conservative group. 6 cases belonged in ADL-4 of poor prognosis in the conservative group but none did from the operative group. 8 cases died in the conservative group and 3 cases in the operative group. There were 9 cases of the excellent recovery in 21 cases of ADL-1 in the operative group and they returned to the previous ocupation or to the out-door labor. Another characteristic seen in the operative group was rare occurence of complications such as G. I. bleeding, respiratory infection, decubitus and urinary infection.<BR>As a conclusion, though the number of the cases are not too sufficient for comparison, it can be said that there is the reasonable indication of surgery for the mild or moderate group of the lateral type of intracerebral hematoma.
- The Japanese Society on Surgery for Cerebral Strokeの論文
著者
関連論文
- 討議
- 超早期手術の再評価について : 高血圧性外側型脳出血166例の検討
- 重症破裂脳動脈瘤症例に対する超早期手術の経験(発症8時間以内の手術) : 特に脳底槽反復洗滌法併用の利点
- Cryptic AVMの発見法および自験16症例の臨床・病理学的検討
- ?胞型髄膜腫について
- 激症型破裂脳動脈瘤の臨床と病理 (クモ膜下出血--内科が知りたい脳外科領域)
- 激症経過をとる脳動脈瘤破裂症例の臨床・病理学的検討
- 【指定発言】
- 住民健康管理のための試み:医療連携を活用しながら
- よくかむ・よく生きる
- 痴呆対策への提言
- 脳高次機能から見た老化の評価と指標
- 急性期脳外科治療の現況と機能予後(脳血管障害治療の最前線 : 外科vs内科vsリハ科)
- 外側型脳内出血における運動麻痺--主として上肢および下肢の麻痺の解離について
- 原発性脳橋出血手術におけるThe′one and a half syndrome′の4例について
- 脳内血腫におけるPantopaque血腫腔造影とそのStereotaxic evaluation
- ボケは防げる, 治せる
- 脳内血腫を合併した成人型もやもや病9例の臨床的検討
- もやもや病脳血管の電顕的観察:-特に出血と関連する穿通枝動脈について-
- 広範な頭部顔面の損傷を合併した顎骨開放性重複骨折の3例
- 高血圧性脳橋出血の臨床と病理:-意識下に長期生存した一手術施行例における検討-
- 45. 重症破裂脳動脈瘤症例に対する脳底槽反復洗滌法併用の検討
- 38. 脳動脈瘤直達手術における Temporary Clipping の遮断許容時間について
- STA-MCA吻合術における両分枝および他部動脈との間の動脈硬化度の差異について
- 意識障害が昏妄以下の軽中等症例の手術適応について:-外側型出血に対する超早期手術の場合-
- TIAおよびminor strokeに対するSTA-MCA吻合術:(20症例の経験から)
- 外側型脳内出血に対する超早期手術:-特にCT導入後の問題点について-
- 43. 小型immature berry aneurysmに対する診断と外科治療
- 重症脳梗塞のCT像:-脳梗塞モデル犬との対比-