Miyahara Kosuke, Fujitsu Kazuhiko, Yagishita Saburo, Ichikawa Teruo, Takemoto Yasunori, Okada Tomu, Niino Hitoshi, Shiina Takeki
Department of Neurosurgery, National Hospital Organization Yokohama Medical Center, Yokohama, Kanagawa, Japan.
Neurol Med Chir (Tokyo). 2011;51(1):52-5. doi: 10.2176/nmc.51.52.
An 80-year-old male presented with a chronic encapsulated intracerebral hematoma (CEIH) with surrounding edema under the right frontal lobe manifesting as slow exacerbation of disturbance of orientation and gait. He had a history of cerebral infarction with an asymptomatic cavernous angioma in the right frontal lobe. The CEIH was diagnosed as bleeding from the cavernous angioma, and surgical removal was performed. The hematoma was chronic and covered by a thick capsule. In addition, mass tissue covered with the organized hematoma was found near the capsule, which was excised and found to be a cavernous angioma. CEIH is a special type of intracerebral hemorrhage, and bleeding from a cavernous angioma is occasionally seen. CEIH should be considered in the case of a hemorrhagic intracranial lesion with a chronic, progressive course with capsule formation and edema around the lesion. The source of bleeding is unknown in about half of the reported cases, and occult vascular malformation may be involved, necessitating care in diagnosis.
一名80岁男性，右额叶下方出现慢性包裹性脑内血肿（CEIH）并伴有周围水肿，表现为定向障碍和步态缓慢加重。他有脑梗死病史，右额叶有一个无症状海绵状血管瘤。该CEIH被诊断为海绵状血管瘤出血，并进行了手术切除。血肿为慢性，被一层厚包膜覆盖。此外，在包膜附近发现了覆盖有机化血肿的肿块组织，将其切除后发现是一个海绵状血管瘤。CEIH是一种特殊类型的脑出血，偶尔可见海绵状血管瘤出血。对于具有慢性、进行性病程且病变周围有包膜形成和水肿的出血性颅内病变，应考虑CEIH。在约一半的报告病例中，出血来源不明，可能涉及隐匿性血管畸形，诊断时需谨慎。
