脳卒中の外科
Online ISSN : 1880-4683
Print ISSN : 0914-5508
ISSN-L : 0914-5508
視野障害よりみた側頭葉・後頭葉脳内血腫の手術適応
河野 道宏瀬川 弘武笠 晃丈矢崎 弘人中冨 浩文佐野 圭司
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1998 年 26 巻 3 号 p. 153-157

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We performed a follow-up study of the visual field in 10 patients with temporo-occipital subcortical cerebral hematoma. The hematoma location was: temporal (3 patients), occipital (4 patients) and temporo-occipital (3 patients). In 7 patients in whom hematoma was 30mm or larger in diameter, surgical treatment was applied, whereas conservative treatment was performed in the other 3 in whom hematoma was under 30mm in diameter and whose visual field defect was slight. In all of 7 patients who underwent surgical treatment, severe visual field defect was recognized. However, visual field was almost fully recovered except for 3 patients who were left with only quadrant hemianopsia. In conclusion, the prognosis of impaired visual field was unexpectedly good with appropriate treatment. When we discuss surgical indication for a subcortical hematoma, not only mortality but functional prognosis should be considered. We considered that a patient with subcortical hematoma that is larger than 30mm in diameter should be treated surgically even if his/her consciousness is not disturbed and only visual field defect is present.

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