Perimesencephalic Nonaneurysmal Subarachnoid Hemorrhage Caused by Physical Exertion
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概要
- 論文の詳細を見る
The clinical characteristics of perimesencephalic nonaneurysmal subarachnoid hemorrhage (SAH) caused by physical exertion were analyzed to investigate the causes and mechanisms of perimesencephalic nonaneurysmal SAH. Nine of 209 patients with spontaneous SAH were identified as having perimesencephalic nonaneurysmal SAH. Perimesencephalic nonaneurysmal SAH in four males and three females was precipitated by exertion. Age, sex predominance, type of exertion, symptoms, loss of consciousness during bleeding, clinical grade, angiographic spasm, hydrocephalus, delayed ischemic deficit, rebleeding, hypertension, and outcome were evaluated in these seven patients. Outcomes were assessed using the Glasgow Outcome Scale. Patients showed male predominance (57.1%), relatively young age (mean 50 years), low frequency of hypertension (28.6%), good clinical grade (World Federation of Neurological Surgeons grade I or II), and excellent outcomes including no rebleeding, no symptomatic hydrocephalus, and no delayed ischemic deficits. The type of exertion was swimming in two patients, golfing in two patients, heavy lifting in two patients, and bending forward during gymnastics in one patient. Physical exertion including components of the Valsalva maneuver is an important predisposing factor for perimesencephalic nonaneurysmal SAH. Such physical exertion produces increased intrathoracic pressure, which blocks the internal jugular venous return, resulting in elevated intracranial venous pressure or mechanical swelling of the intracranial veins, and leads to venous or capillary breakdown.
- 社団法人 日本脳神経外科学会の論文
- 2006-06-15
著者
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HIGUCHI Takafumi
Departments of Immunology, Kurume University School of Medicine
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MATSUYAMA Takeshi
Department of Pediatrics, Fussa Hospital
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Higuchi Takafumi
Department Of Cardiology Tenri Hospital
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Higuchi Takafumi
Department Of Critical Care And Emergency Medicine Nara Medical University
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OKUCHI Kazuo
Department of Critical Care and Emergency Medicine, Nara Medical University
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SEKI Tadahiko
Department of Critical Care and Emergency Medicine, Nara Medical University
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MURAO Yoshinori
Department of Critical Care and Emergency Medicine, Nara Medical University
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Seki Tadahiko
Department Of Emergency And Critical Care Medicine Nara Medical University
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Matsuyama Takeshi
Department Of Emergency And Critical Care Medicine Nara Medical University
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Okuchi Kazuo
Department Of Critical Care And Emergency Medicine Nara Medical University
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Murao Yoshinori
Department Of Critical Care And Emergency Medicine Nara Medical University
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Matsuyama Takeshi
Department Of Critical Care And Emergency Medicine Nara Medical University
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