脳動脈瘤破裂症例における脳循環動態 : 第2報局所脳血流量よりの検討

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Seventy-five studies of regional cerebral blood flow (rCBF) were performed in 42 patients with ruptured intracranial aneurysms. The measurement of rCBF was made by ^<133>Xe intra-arterial method using 32 detectors.A computer system was used for automatic calculations of rCBF by stochastic and initial flow analysis. The changes in rCBF were analyzed under various pathophysiological conditions following rupture of intracranial aneurysms and were discussed with special reference to occurrence of focal ischemia and abnormal vascular response. The results were as follows;1) The degree of flow abnormalities and the occurrence of focal ischemia correlated well with the clinical grade of neurological deficits. Most of the grade IV patients (classification of Hunt and Hess) showed marked decreaseof mean CBF, which was below 30 ml/100 g/min. Furthermore, these patients also had marked ischemic foci, where the rCBF was below 20 ml/100 g/min.2) Most of the patients with angiospasm showed focal ischemia in the regions supplied by the involved arteries.All of the patients with diffuse angiospasm of severe grade showed focal areas of decreased flow below 30 ml/100g/min, in addition to a diffuse reduction in rCBF. The relief of angiospasm was followed by the increase of mean CBF and rCBF in the ischemic focus.3) The patients with low density lesions in CT showed more depressed values of mean CBF than those without low density lesions, but there was little difference in rCBF in the ischemic foci between both groups.4) Severe neurological deficits were found in cases with intracerebral hematoma and hydrocephalus. rCBF studies showed focal decreased flow below 30ml/100g/min corresponding to the area of hematoma as well as generalized reduction in rCBF. Twelve studies in patients with hydrocephalus showed marked reduction in mean CBF, which was below 30ml/100g/min.5) Imparied CO_2-response and autoregulation were found in patients with severe neurological deficits, severe degree of angiospasm and marked depression of mean CBF.
日本脳神経外科学会の論文
1978-11-15

脳動脈瘤破裂症例における脳循環動態 : 第2報局所脳血流量よりの検討

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脳動脈瘤破裂症例における脳循環動態 : 第2報 局所脳血流量よりの検討

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脳動脈瘤破裂症例における脳循環動態 : 第2報局所脳血流量よりの検討