脳出血




























脳出血

Intracerebral hemorrhage 2.jpg
脳出血

分類および外部参照情報
診療科・
学術分野
救急医学

ICD-10
I61

ICD-9-CM
431
MeSH
D002543

脳出血（のうしゅっけつ）とは、頭蓋内の出血病態の総称であり、一般には脳溢血（のういっけつ）として広く知られている。脳出血は脳内への出血と脳周囲への出血に分類される。医学的には狭義での脳内出血のみを指すことがある。




  • 脳内出血（いわゆる脳出血のことで、高血圧性脳出血を含む）

  • クモ膜下出血

  • 慢性硬膜下血腫

  • 出血性脳梗塞



急性頭蓋内血腫


頭蓋内出血は外傷性と非外傷性に分けられ、それぞれ急性、亜急性、慢性に分類される。この場合、急性は発症後3日以内に生じるものをいい、亜急性は4日以降20日以内に生じるもの、慢性は21日以降に生じるものをいう。


外傷性頭蓋内出血の多くは急性頭蓋内血腫 acute intracranial hematoma を形成する。この急性頭蓋内血腫は血腫の部位により次の3つに分類され、概ね記載順に合併する脳損傷は少ない。



  • 急性硬膜外血腫

  • 急性硬膜下血腫

  • 急性脳内血腫 acute intracerebral hematoma


※急性脳内血腫の多くは脳挫傷に伴うもので、受傷後数時間から半日で形成されることが多い。発生部位に応じた神経脱落徴候と意識障害が生じ、血腫が大きければ脳ヘルニアの徴候を生じる。正中偏位を生じるような大きな血腫は手術的に除去するが、部位によっては神経脱落徴候の後遺症が残る。


関連項目


  • 脳神経外科学







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