Neurological Surgery 脳神経外科43巻2号

2015年02月発行

連載 脳卒中専門医に必要な基本的知識

（7）くも膜下出血—最近の動向

著者： 石原秀行¹ 杉本至健¹ 白尾敏之¹ 鈴木倫保¹

所属機関： ¹山口大学脳神経外科

ページ範囲：P.159 - P.166

Ⅰ．はじめに
　わが国における疫学研究では，くも膜下出血の発症数は年間10万人あたり約20人である¹⁰⁾．人種別にみると日本人では発症率が高い疾患である．
　先進国ではこの約40年間に死亡率は約60%から約30%に低下している^13-15)．1960年代に脳神経外科手術に手術用顕微鏡が導入されて以降も，絶え間なく続く治療と管理の進化が寄与しているものと考えられる．1990年代にはコイルを使用した血管内治療が開発され，急性期治療の幅を大きくした．また，脳血管攣縮に対する治療の改善も予後改善に貢献しているものと考えられる．本稿ではくも膜下出血に関連する最近の話題について概説する．

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