日本救急医学会雑誌
Online ISSN : 1883-3772
Print ISSN : 0915-924X
ISSN-L : 0915-924X
緊急手術を行った脳動静脈奇形による小児小脳出血の2例
増山 祥二府川 修伊藤 誠康三谷 慎二伊藤 健司
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2000 年 11 巻 7 号 p. 351-356

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Two cases of cerebellar hemorrhage resulting from ruptured arteriovenous malformations (AVM) in children are reported. The patients were admitted to our clinic in a comatose state, and CT scans revealed the presence of a cerebellar hemorrhage. The hematoma was partially enhanced using a contrast medium, and arteriovenous malformations were observed in both cases. The intracranial pressure was elevated in both cases, so a cerebral angiography was not performed. The patients were immediately admitted to surgery, and the hematomas and arteriovenous malformations were removed. In both cases, a one-stage operation was performed. One patient was able to return to school after 90 days, and recovered completely, with no neurological deficits. The second patient required rehabilitation for 300 days after the operation and retained right VII-X cranial nerve palsies. Surgery during childhood for cerebellar hemorrhages resulting from arteriovenous malformations has been discussed in the literature. Some authors have recommended that a two-stage operation be performed for patients in a comatose state, such as ours. However, emergency one-stage operations are required in extremely critical cases, such as those of the two patients reported here.

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