Neurological Surgery 脳神経外科37巻8号

2009年08月発行

研究

初回脳血管造影検査で出血源不明の，非外傷性くも膜下出血症例の検討：特に中脳周囲槽くも膜下出血症例のCT上の血腫の局在について

著者： 仲川和彦¹ 青柳傑¹ 前原健寿¹ 玉置正史¹ 稲次基希¹ 河野能久¹ 武川麻紀¹ 山本信二² 大野喜久郎¹

所属機関： ¹東京医科歯科大学脳神経外科 ²富士吉田市立病院脳神経外科

ページ範囲：P.771 - P.778

Ⅰ．はじめに

　初回のdigital subtraction angiography（DSA）で出血源が不明の非外傷性のくも膜下出血（subarachnoid hemorrhage：SAH）は，約5～20％の頻度でみられるとされ，これまでも数多くの報告がある^2,6,7,10,13)．通常，入院時のcomputed tomography（CT）上の血腫の分布所見から，perimesencephalic nonaneurysmal SAH（PMSAH）と，それ以外のnon-PMSAHに分類され，前者は再出血もなく予後良好とされる．PMSAHはオランダのグループのvan Gijnらによって初めて報告され¹⁴⁾，その後同グループのRinkelらによってそのCT所見の血腫の特徴的な分布様式が定義された⁹⁾．

　しかし，PMSAHのCT所見の定義に関して表現上のあいまいさの問題があり，また，必ずしもその定義を満たさないvariantの報告もある¹²⁾．これらのことを念頭に置き，今回われわれは，当科で経験した初回DSAで出血源が不明のSAH症例を検討した．

参考文献

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