CT定位的血腫吸引術の8日後に同一部位に再発した被殻出血の1例

抄録

We describe the case of a 58-year-old male with hypertensive intracerebral hemorrhage recurrence in the same putaminal region 8 days after CT-guided stereotactic aspiration of the initial hemorrhage. On admission, the patient presented left-sided motor weakness, and CT scan revealed right putaminal hemorrhage 12ml in volume. A repeat CT scan performed 17 hours after the initial CT showed enlargement of the hematoma up to 33ml with ventricular extension. CT-guided stereotactic aspiration of the hematoma was performed 4 days after the onset. Post-operative CT scan showed 85% removal of the hematoma and no postoperative bleeding. Blood pressure of the patient was not well controlled during a week after the operation. Eight days after the operation, the patient complained of headache and his consciousness level deteriorated slightly. CT scan at that time demonstrated recurrent hemorrhage of about 19ml in volume within the same putaminal region. The patient was treated conservatively and with hyperosmolar agents. We discuss possible pathogeneses of the recurrence of the hypertensive intracerebral hemorrhage in the same region.