脳動脈瘤,術後頭蓋内圧の経時的推移の検討

概要

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Continuous recordings of intracranial pressure (ICP) in 41 postoperative cases with ruptured saccular aneurysm were made by subdural balloon method. The time course of ICP roughly fell into four types. Type 1 : ICP did not exceed 18 mm Hg all through the course. Type 2 : ICP elevated up to 18-37 mm Hg range, between 10 to 12 hours following surgery. Type 3 : ICP elevated above 37 mm Hg during the first 12 hours. Type 4 : ICP was controlled by the ventricular drainage which was placed at the time of operation. The preoperative factors which had most significant relationship to those four types were; the interval from the last subarachnoid hemorrhage to operation, the presence of arterial spasm before operation and clinical grade described by Hunt and Hess. Other factors such as number of attacks of subarachnoid hemorrhage and location of the aneurysm had little relationship to the ICP types. It was found that the continuous monitoring of ICP has a considerable value in controlling the elevated ICP in postoperative cases with ruptured aneurysm, especially in those who have high operative risks.
日本脳神経外科学会の論文