椎骨動脈撮影による外傷性後頭蓋窩血腫の診断

• Published in: Neurologia medico-chirurgica Vol. 16; no. 5; pp. 397 - 403
• Main Authors: 福光太郎, 山下純宏, 三輪佳宏, 村田高穗, 徳力康彦
• Format: Journal Article
• Language: Japanese
• Published: 日本脳神経外科学会 1976
• ISSN: 0470-8105

外傷性後頭蓋窩血腫の診断について“The single important factor in making the diagnosis of extradural hematoma of the posterior fossa is a high index of suspicion that such a lesion may exist. ”と述べたSchneiderらの言葉は現在においてもまったく正しい. 特に急性例において, 神経学的所見のみから後頭蓋窩血腫を正確に診断することはきわめて困難であろう. ColemanとThompsonの記載に従えば, “There is a history of a blow upon the back of the head severe enough to produce a fracture of the skull, but which may cause unconsciousness. This is followed by headache of gradually increasing severity and is usually accompanied by nausea and vomiting. Drowsiness and restlessness appear and progress until the patient lapses into unconsciousness. However, during the drowsy state several things may be noted. The patient prefers to lie on one side and will promptly return to the same side when placed upon his back. Nuchal rigidity develops, nystagmus may or may not be present, and the deep reflexes disappear. As unconsciousness deepens, generalized hypotonia develops, the pulse and resporations become irregular, and death is imminent unless there is prompt surgical intervention with removal of the clot. ”と表現されており, おそらくこれで十分であろう.