Sadatomo Takashi, Yuki Kiyoshi, Murakami Taro, Migita Keisuke, Taniguchi Eiji, Kodama Yasunori
Department of Neurosurgery, National Hiroshima Hospital, Hiroshima, Japan.
Hiroshima J Med Sci. 2003 Dec;52(4):91-7.
A 35-year-old man presented with a sudden headache and disturbance of consciousness. On admission, his consciousness level was Japan Coma Scale 100. Computed tomography disclosed a subarachnoid hemorrhage (SAH) and right cerebellar hematoma. Angiography was performed and, at first, arteriovenous malformation of the posterior fossa was diagnosed. Then external decompression of the posterior fossa and ventricular drainage were performed, followed by barbiturate therapy. Repeat angiography revealed that the lesion was a venous angioma with arteriovenous shunts. On day 37, subtotal removal of the lesion was performed. Intraoperatively, acute brain swelling emerged and partial internal decompression of the right cerebellar hemisphere was performed. The postoperative course was comparatively good and the patient was discharged with very mild ataxia. The patient is now being followed up in our outpatient clinic.
一名35岁男性因突发头痛和意识障碍入院。入院时,其意识水平为日本昏迷量表100级。计算机断层扫描显示蛛网膜下腔出血(SAH)和右侧小脑血肿。进行了血管造影,最初诊断为后颅窝动静脉畸形。随后进行了后颅窝外部减压和脑室引流,接着进行了巴比妥类药物治疗。重复血管造影显示病变为伴有动静脉分流的静脉血管瘤。在第37天,对病变进行了次全切除。术中出现急性脑肿胀,对右侧小脑半球进行了部分内减压。术后病程相对良好,患者出院时仅有非常轻微的共济失调。该患者目前正在我们的门诊进行随访。