Neurological Surgery 脳神経外科37巻8号

2009年08月発行

連載 脳神経外科疾患治療のスタンダード

9．意識障害

著者： 太田富雄¹

所属機関： ¹㈶大阪脳神経外科病院

ページ範囲：P.811 - P.820

Ⅰ．はじめに

　かつて脳疾患の診断・治療には，十二分の神経学的知識と経験が必須で，病変の有無・存在部位の診断に，神経学的知識を駆使し一生懸命診察した．その後，CTやMRIの導入により，病変部位は形態学的に微細かつ正確に診断可能となり，したがって，外科的治療に未踏の領域（no man's land）はなくなりつつある．

　このように病変に関する形態学的情報が充実することで，それに伴う機能的情報の把握が極めて重要となってきた．特に，脳卒中や頭部外傷などにおける意識障害の重症度判定とその時間的推移の観察・記載は，これまで以上に迅速性かつ正確性が要求され，時機に後れた対応が治療予後を左右する最重要因子の1つになってきた．

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