Yamaguchi K, Nishizaka T, Tanji H, Higa K, Furukawa F
No Shinkei Geka. 1977 Feb;5(2):153-6.
A 45-year-old man suddenly developed right hemiparesis and aphasia during work and lost conciousness next day, when he was admitted to us. Lumbar puncture showed bloody C.S.F. with the initial pressure of 220 mm H2O. Physical examination revealed hypertension and arteriosclerosis. Cerebral angiogram revealed an arteriovenous malformation in the left frontoparietal-parasagittal region and a saccular aneurysm at the left internal carotid-posterior communicating artery junction. In addition, the existence of putaminal hematoma was suspected on account of the displacement of the left anterior cerebral artery and the left lenticulostriate arteries. On the fourth day after admission his consciousness returned and the right hemiparesis gradually improved. One month later the disappearance of the displacement of the anterior cerebral artery was demonstrated by cerebral angiogram. A frontoparietal craniotomy was done and no hematoma was found around the arteriovenous malformation and the basis of the aneurysm did not adhere to the temporal lobe. Taking these findings into consideration, it is presumed that the hematoma in putaminal region was due to neither arteriovenous malformation nor aneurysm but was a hypertensive intracerebral hemorrhage.
一名45岁男性在工作期间突然出现右侧偏瘫和失语，次日入院时失去意识。腰椎穿刺显示脑脊液呈血性，初压为220mmH₂O。体格检查发现高血压和动脉硬化。脑血管造影显示左侧额顶叶-矢状窦旁区域存在动静脉畸形，左侧颈内动脉-后交通动脉交界处有一个囊状动脉瘤。此外，由于左侧大脑前动脉和左侧豆纹动脉移位，怀疑存在壳核血肿。入院后第四天，他的意识恢复，右侧偏瘫逐渐改善。一个月后，脑血管造影显示大脑前动脉移位消失。进行了额顶开颅手术，在动静脉畸形周围未发现血肿，动脉瘤底部未与颞叶粘连。综合这些发现，推测壳核区域的血肿既不是由动静脉畸形也不是由动脉瘤引起的，而是高血压性脑出血。
