Takahashi Satoshi, Yazaki Takahito, Nitori Nobuhiro, Kano Tadashige, Yoshida Kazunari, Kawase Takeshi
Department of Neurosurgery, Mita Hospital, International University of Health and Welfare, Tokyo, Japan.
Neurol Med Chir (Tokyo). 2011;51(7):515-8. doi: 10.2176/nmc.51.515.
A 78-year-old Japanese man with a history of colon cancer was referred to our department of neurosurgery for the management of asymptomatic left chronic subdural hematoma (CSDH). He was receiving bevacizumab therapy for colon cancer, and the size of the CSDH increased or decreased depending on bevacizumab administration. Simple drainage was performed because of the risk of a critical increase in the size of CSDH during bevacizumab therapy, but since the CSDH was organized and firm, the drainage was insufficient. Therefore, neuroendoscope-assisted craniotomy was performed, and the organized CSDH was almost completely removed. The present case indicates the possible involvement of bevacizumab in the occurrence of CSDH and the efficacy of the neuroendoscopic approach in the surgical treatment of organized CSDH.
一名78岁有结肠癌病史的日本男性因无症状性左侧慢性硬膜下血肿（CSDH）被转诊至我院神经外科。他正在接受结肠癌的贝伐单抗治疗，CSDH的大小随贝伐单抗的给药而增减。由于在贝伐单抗治疗期间CSDH大小有急剧增加的风险，故进行了简单引流，但由于CSDH已机化且质地坚韧，引流不充分。因此，实施了神经内镜辅助开颅手术，几乎完全清除了机化的CSDH。本病例表明贝伐单抗可能与CSDH的发生有关，以及神经内镜方法在机化CSDH手术治疗中的有效性。
