Yasui T, Komiyama M, Kishi H, Yagura H, Fu Y, Nagata Y, Tamura K
Department of Neurosurgery, Osaka City General Hospital, Japan.
Surg Neurol. 1995 Jan;43(1):61-7. doi: 10.1016/0090-3019(95)80041-e.
Acute spontaneous subdural hematoma is very rare. We have encountered four such cases and verified the arterial origin of the bleeding at operation. None of the patients had a history of head trauma, and each had developed sudden onset of headache and other neurologic deficits, which simulate other cerebrovascular diseases. CT directly revealed subdural hematoma but gave no indication as to the source of the bleeding. Cerebral angiography was performed in all cases, with three of them showing localized extravasation of the contrast material into the subdural space. The extravasation was noted usually in the late arterial phase. This is a useful finding for diagnosing this disease and localizing the bleeding point. It is expected that with more routine use of cerebral angiography in cases of acute spontaneous subdural hematoma, extravasation of the contrast medium will be seen more frequently.
急性自发性硬膜下血肿非常罕见。我们遇到了4例这样的病例，并在手术中证实了出血的动脉来源。所有患者均无头部外伤史，且均突然出现头痛及其他神经功能缺损，这些症状类似于其他脑血管疾病。CT直接显示硬膜下血肿，但未提示出血来源。所有病例均进行了脑血管造影，其中3例显示对比剂局部外渗至硬膜下间隙。外渗通常在动脉晚期被发现。这一发现对于诊断该病及确定出血点很有用。预计随着在急性自发性硬膜下血肿病例中更常规地使用脑血管造影，对比剂外渗将更频繁地被观察到。
