小脳梗塞の外科治療:-治験例と考察-

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Recentry we have experienced a case of acute cerebellar infarction, which presented clinically as a posterior fossa mass and had been surgically treated. A 60 years old male patient had suffered from hypertension and diabetes mellitis for several years. He had sudden onset of dizziness, nausea, vomiting and headache, and was admitted to K.T. Hospital on Oct. 3 1978. On neurological examination, he was restlessness and blood pressure was 240/140 mmHg. 3 days after from onset, he became semicomatose. On Oct. 9, 6 days after from onset, he was transfered to our hospital because of further study and therapy. Papilledema on the both sides and respiratory disturbance were noted. On admission, he was semicomatose and his respiration was shallow and ataxic. The light reflex was sluggish, right gag reflex was not elicited. Right hemiparesis and both Babinski's sign, Chaddock's sign were positive.<BR>CT scan revealed low density area at the right cerebellar hemisphere and hydrocephalus. Right VAG demonstrated the mass of lower part of cerebellum and right AICA was not visualized. Ventricular drainage was carried out for first aid therapy on the day of admission. Positive contrast ventriculography revealed anterior shift of 4th ventricle and obstruction at the lower-posterior part of 4th ventricle. After the drainage, he regained consciousness and respiratory disturbance was disappeared. 9 days after from onset, he became drowsy again. In order to relieve the brain stem compression, suboccipital decompressive operation was done (Oct, 12). At the operation, right cerebellar hemorrhagic infarction and right tonsillar herniation were noted. Torkildsen's shunt operation was placed because of poor flow of CSF from Foramen Magendie. 3 months after the operation, he has no neurological deficits except right accessory nerve palsy.
The Japanese Society on Surgery for Cerebral Strokeの論文

小脳梗塞の外科治療:-治験例と考察-

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