亜急性期に急性増悪した急性硬膜下血腫の検討

抄録

With increasingly frequent use of CT scanning in less severely head injured conscious patients, the demonstration of minimal “asymptomatic” acute subdural hematoma (ASDH) is becoming an increasingly frequent finding, and this sometimes presents the neurosurgeon with a difficult management decision. We have studied about the pathogenesis of the mild ASDH through three patients who demonstrate relatively few neurological abnormalities with ASDH on admission. All patients were managed conservatively in the first instance, but rapid deterioration emerged in sub-acute phase after injuries. They required operation for their residual and/or enlarged ASDH and the midline shift in emergency though the craniotomy or the burr-hole surgery. The outcome was uniformly excellent for all patients. On the basis of this study, we recommend that the attention against the rapid deterioration in sub-acute phase after the head injury should be paid continuously for the initially conscious patients with minimal ASDH.