著者

太田 富雄 和賀 志郎 半田 肇 斉藤 勇 馬杉 則彦 竹内 一夫 鈴木 二郎 高久 晃

出版者

一般社団法人 日本脳卒中の外科学会

雑誌

脳卒中の外科研究会講演集 (ISSN:03878031)

巻号頁・発行日

vol.3, pp.61-68, 1975-06-06 (Released:2012-10-29)

参考文献数

15

被引用文献数

1

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Disturbance of consciousness in acute stage, so far, has been classified by using a set of technical terms such as coma, stupor, somnolence, confusion and so on. However, the definition of such terms has a different nuance from one clinic to another, and this made the comparison of the data on the same topics incomplete and incorrect. Because of this, it is true in most neurosurgical clinics in Japan that the severity of the disturbance of consciousness has long been described with grades of the responsiveness to different stimuli laden to the patients.In order to obtain an universal classification on this matter, possibility ef quantitative and qualitative gradings has been searched by means of combining the following three factors; arousal, responsiveness to mechanical and verbal stimuli, and the contents of consciousness. Table shows our proposal of quantitative and partially qualitative grading of the disturbance of consciousness in acute stage. Deep coma, coma and semicoma in the contemporary usage belong to grade III in our classification; stupor, lethargy, hypersomnia, somnolence, and drowsiness belong to grade II, and delirium, confusion, and senselessness belong to grade I.Features of this new grading of the disturbance of consciousness in acute stage have been discussed.Table: New grading of level of consciousness in acute stage (So-ocalled 3-3-9 formula) Grade III. The patient is unable to be arousen with any forceful mechanical stimulus, and(300) 3. is not responsive at all except for change of respiratory rhythm,(200) 2. is responsive with slight movements including decerebrate response, or(100) 1. is responsive with combative oropurposeful movements. Grade II. The patient is able to be arousen with mechanical or verbal stimuli, and(30) 3. is barely arousen with repeated mechanical stimuli,(20) 2. is arousen with loud voice or shaking shoulders, or(10) 1. is arousen easily with usual voice. Grade I. The patient is awake without any stimulus, and(3) 3. is quite senseless and cannot tell even his own name or date of birth,(2) 2. is disorientated to time, place, and person, or(1) 1. is seemingly alert but not fully so. “R” and“Inc” are added to the grading in case of restlessness and incontinence.

著者

永井 正一 栗本 昌紀 西嶌 美知春 遠藤 俊郎 高久 晃

出版者

日本脳神経外科コングレス

雑誌

脳神経外科ジャーナル = Japanese journal of neurosurgery (ISSN:0917950X)

巻号頁・発行日

vol.5, no.6, pp.450-453, 1996-11-20

参考文献数

8

被引用文献数

2

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開頭術後の合併症としての遠隔部脳内血腫は報告が少なくまれである.われわれは脳動脈瘤術後にテント上下に多発性の遠隔部脳内血腫が発生した1症例を経験したので報告する.原因として,髄液排除による静脈環流障害および術中術後の血圧変動が考えられた.過度の髄液排除を避けることはもとより,術中術後の血圧管理に最大限の注意を払うことが必要と思われた.

著者

高久 晃

出版者

日本脳神経外科コングレス

雑誌

脳神経外科ジャーナル (ISSN:0917950X)

巻号頁・発行日

vol.19, no.5, pp.409-411, 2010-05-20

著者

高久 晃 福井 仁士 JUNG Hee-Won HAN Dae Hee O-Ki Kwon CHO Byung-Kyu CHOI Kil Soo 森田 明夫 若井 晋 島 健 端 和夫 早川 徹 桐野 高明

出版者

日本脳神経外科学会

雑誌

Neurologia medico-chirurgica (ISSN:04708105)

巻号頁・発行日

vol.38, no.5, pp.305-321, 1998-05-15