No shinkei geka. Neurological surgery
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A rare case of thrombosed AVM presenting temporal lobe epilepsy is reported. A 27-year old man was admitted to our hospital because of a 7-year history of temporal lobe epilepsy. He had also suffered from generalized seizure since he was 6 years old. ⋯ Conventional EEG showed focal spike discharges from the left fronto-central lead, and subdural EEG recordings showed intermittent spike discharges from the medial side of the left temporal lobe. A 5 cm temporal lobectomy was performed and a thick fibrous mass adjacent to the hippocampoamygdala complex was removed. Histopathological examination demonstrated a thrombosed AVM surrounded by gliotic neural tissue.
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The clinical course of ten cases of head injury complicated with multiple systemic injuries were studied by comparing two groups divided according to the presence or absence of associated coagulative-fibrinolytic abnormality. All these cases had intracranial hemorrhagic lesions proven by the high density area in the initial CT scan. Five cases showed signs of disseminated intravascular coagulation (DIC) as evidenced by decreased counts of platelet, and/or elevated value of FDP at the time of admission. ⋯ S., died of acute renal failure and multiple organ failure. In contrast with these cases, five cases without signs of DIC intracranial hematomas did not enlarge in spite of the similar neurological conditions to the former group. In head injured patients with systemic injury, DIC frequently causes secondary hemorrhage in the intracranial lesions of minor severity.