重症頭部外傷として救急搬送されるも脳動脈瘤破裂による非外傷性急性硬膜下血腫であった１例

抄録

The patient, a 64–year–old man, was found lying on the bypass road and called emergency medical services. Computed tomography (CT) showed right acute subdural hematoma with midline shift, and we decided to perform craniotomy to remove the hematoma. After removal of the hematoma, micro­scopic examination revealed a small aneurysm in the peripheral portion of the middle cerebral artery running to the cerebral surface of the temporal lobe. The aneurysm was trapped, and the specimen was submitted for pathological examination. Patho­logi­cally, a true aneurysm was suspected. Acute sub­dural hematoma is usually caused by head trauma, but in rare cases, it can be caused by a ruptured aneurysm. In the case of non–traumatic subdural hematoma, not only decompression but also radical treatment is required, which changes the treatment strategy.