Neurologia medico-chirurgica
Online ISSN : 1349-8029
Print ISSN : 0470-8105
ISSN-L : 0470-8105
特発性小児小脳出血の2例
安芸 都司雄中村 恒夫岩田 隆信市来崎 潔塩原 隆造戸谷 重雄玉井 誠一
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1981 年 21 巻 4 号 p. 419-425

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It is generally accepted that intracerebellar hemorrhages account for ten per cent of all intracerebral hemorrhage, but reports of intracerebellar hemorrhages in children under fifteen years of age are rare. Two cases of intracerebellar hemorrhage in children were experienced.
Case 1-A two-year-old boy was admitted because of vomiting and ataxia which appeared two days after a minimal head trauma. A CT scan showed a cerebellar hemorrhage. After a gradual recovery another hemorrhage attack occurred six days after admission and he again started vomiting and became drowsy. Removal of the hematoma was carried out. The histological examination of the wall showed an angiomatous malformation. Case 2-A thirteen-year-old girl had occipital pain for two months prior to admission. A CT scan showed a low density area in the cerebellum. Then she suddenly developed a severe headache and drowsiness and was admitted as an emergency case. Another CT scan showed that the low density area observed in the initial examination was replaced by high density, suggesting a hemorrhage into the cystic tumor. She had a coma, tetraplegia and respiratory arrest after a ventriculo-peritoneal shunt was established. Removal of the hematoma was carried out fifteen hours after the onset. Histologically, no tumor tissue was found, and the cystic wall showed vascular proliferation and mild gliosis. The hemorrhage may have been due to a cystic astrocytoma or hemangioblastoma. The postoperative courses were excellent in both cases.
Operative results in children, in the acute phase were good with satisfactory functional recovery in all reported cases. This suggests that surgery in children should be positively indicated, even if serious neurological findings are present.
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