尾状核部高血圧性脳出血の手術適応

概要

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Nine cases of hypertensive caudate hemorrhage diagnosed by CT scanning were classified into three types according to extension of the hemorrhage and neurological symptoms.<BR>Type I: The hemorrhage is restricted within the caudate nucleus with slight ventricular hemorrhage in the ipsilateral lateral ventricle. This type is observed in the 5 cases out of 9 cases. Whose consciousness is confusion without any neurological signs. All cases return to their former jobs following conservative treatment.<BR>Type II: The hemorrhage extend to postero-medial direction beyond the caudate nucleus with ventricular hematoma. This type is observed in 2 cases out of 9 cases whose consciousness disturbed as much as confusion to semicoma with hemiparesis. The hematoma is evacuated through frontal approach and ventricular hematoma is also evacuated through perforating point of the intracerebral hematoma with contralateral continuous ventricular drainage. They are also able to return their former job following the operative treatment.<BR>Type III: The hematoma extend to postero-lateral direction beyond the caudate nucleus with the bilateral or third ventricular hematoma. Two cases fall in semicoma with hemiplegia. The same treatment in type II is performed. Recovery of neurological symptoms cannot be expected.<BR>It might be concluded that this classification offer excellent information to decide operative indication and operative method for the caudate hemorrhage.