破裂脳動脈瘤症例の術前・術後の脳血管攣縮の病態についての比較検討

スポンサーリンク

概要

• 論文の詳細を見る

• Pathophysiology of preoperative and postoperative angiospasm in cases with ruptured intracranial ancurysm was studied. Twenty-three cases of ruptured intracranial aneurysm who had neurological signs and symptoms of ischemic lesions caused by cerebral angiospasm (spasm-syndrome) were selected on the basis of symptomatology from 184 consecutive cases with ruptured intracranial aneurysm. These cases were divided into two groups according to the time of development of spasm-syndrome and surgery of aneurysm; those in which spasm-syndrome developed in the preoperative period and those in which spasm-syndrome developed in the postoperative period. In all cases angiospasm in variable degrees was demonstrated on angiograms which were performed after the development of spasm-syndrome. In the cases with preoperative spasm-syndrome clinical signs and symptoms did not become worse after surgery when operation was delayed until spasm-syndrome was improved. Operative results in these cases were fairly good. Postoperative spasm-syndrome frequently occurred in cases in which operation was performed within 10 days after the episode of subarachnoid hemorrhage (SAH). Neurological signs and symptoms in these cases were much worse than those in the cases with preopsrative spasm-syndrome. Characteristic features of postoperative spasm-syndrome at early stages of postoperative periods were extensive diffuse angiospasm together with a round shift of major arteries from the surgically affected side to the opposite on angiograms, and an extensive low density area with compression and deformity of ventricles on computed tomograms, suggesting extensive brain edema on the surgically affected cerebral hemisphere. And then, these findings seen on computed tomograms became cerebral infarction at a later postoperative period. On the other hand, abnormal findings on computed tomograms were not found in 11 of 12 operated cases of ruptured intracranial aneurysm who did not have spasm-syndrome in their clinical courses. Preoperative rCBF measurements showed a marked decrease of cerebral blood flow in the cases with postoperative spasm-syndrome. From this study, it is likely that postoperative spasm-syndrome is the result of cerebral ischemic lesions caused by angiospasm following SAH and surgical infiuences.

• 日本脳神経外科学会の論文
• 1979-06-15

著者

• 榊 三郎

  愛媛大学脳神経外科

• 松岡 健三

  愛媛大学脳神経外科

• 宍戸 豊史

  愛媛大学脳神経外科

• 森 洋二

  愛媛大学脳神経外科

• 尾藤 昭二

  大阪厚生年金病院脳神経外科

• 本崎 孝彦

  愛媛大学脳神経外科

• 郷間 徹

  愛媛大学脳神経外科

関連論文

• 乳癌手術後 10 年を経て孤立性に脊髄髄内へ転移した 1 例
• 横S状静脈洞部硬膜動静脈奇形
• モヤモヤ病に合併した破裂脳底動脈瘤3症例の治療経験-治療方法の選択についての文献的考察-
• Cerebral MR angiography (脳血管磁気共鳴画像法,MRA)の研究(第8報) : 脳動脈瘤に対するMRAの診断能
• 破裂脳動脈瘤術後の慢性期高次脳機能の検討
• 半側顔面痙攣および三叉神経痛例に対する神経血管減荷術における三次元画像解析の有用性
• 破裂脳動脈瘤症例の治療成績ーUrokinaseおよびNicardipine脳槽内投与の効果についてー
• Aggressive papillary tumor of temporal boneの一例
• 43.小脳血管腫を合併した胆道閉鎖症の1例(第18回胆道閉鎖症研究会)
• 多発性転移を示した側頭骨原発のmalignant fibrous histiocytomaの1例
• 頭蓋内髄膜腫に対するtranscatheter embrolization : 摘出腫瘍の病理学的検討
• 外傷性急性硬膜外血腫除去後に続発した両側性慢性硬膜下血腫の一乳児例
• 脳虚血後の脳表血管の反応性について
• 総頸動脈閉塞性病変に対する外科的治療経験
• Carotid-ophthalmic aneurysmの手術 : 手術到達法の選択について
• 腰椎穿刺後に発生した脊髄硬膜下血腫の1例
• Cryptic vascular malformationを合併し、脳出血で発症した硬膜動静脈奇形の1例
• 自然発生した頭蓋内硬膜外血腫の1例
• 開頭術後に合併したtension pneumocephalusの3例
• 15. 椎骨動脈瘤に対する Proximal Ligation:-Ligationの部位と手術成績・予後との関連について-
• 破裂脳動脈瘤症例の術前・術後の脳血管攣縮の病態についての比較検討
• 破裂脳動脈瘤急性期手術症例における術後早期CTによる脳血管攣縮の予測
• 35. 破裂脳動脈瘤急性期症例の髄液中のsuperoxide dismutase 活性および過酸化脂質の推移についての検討

もっと見る 閉じる

スポンサーリンク