破裂脳動脈瘤におけるリスクファクターとしての血管内凝固症候群
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概要
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Platelet aggregability and coagulation and fibrinolytic activities were determined statistically in all cases of ruptured intracranial aneurysms in the acute stage during the waiting period for intentionally delayed operations. The following items were measured: platelet aggregability by screen filtration pressure (SFP), fibrinogen, anti-thrombin-III, partial thromboplastin time, prothrombin time, platelet count, plasminogen, streptokinase euglobulin lysis time and fibrin/fibrinogen degradation products (FDP). It was revealed that in the acute stage of ruptured intracranial aneurysms, systemic coagulation abnormalities similar to the intravascular coagulation syndrome (DIC), which was said to cause abnormal exasperation in the coagulation and fibrinolytic activities, were observed fairly frequently, and further that it had a serious relation to the outcome of the case. Thirteen patients out of 38 cases of ruptured intracranial aneurysms died during the waiting period. Except for one patient who died from a fatal rebleeding, all other 12 patients died from marked brain swelling caused by cerebral vasospasms. In eight patients out of the 12 dead cases, coagulation abnormalities which might be called DIC appeared immediately after bleeding and later marked cerebral vasospasms occurred. DIC following intracranial diseases was reported in serious head injury cases. It was made clear that DIC could also appear in ruptured intracranial aneurysms so that it should be counted as one of the risk factors in the acutestage of ruptured intracranial aneurysms.
- 日本脳神経外科学会の論文
- 1981-10-15
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