高齢者破裂脳動脈瘤患者の間欠的髄液ドレナージ法の試み

概要

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In recent years, the possibility of treating aged patients of ruptured aneurysm has increased with the progress of surgical technology and the spread of endovascular treatment. But prognosis is still poor. Systemic complications caused by lying on a bed over a long period post-operatively are cited as the cause. When continuous cerebrospinal fluid (CSF) drainage is used to prevent symptomatic vasospasm, patients are forced to lie on a bed over a long period. In order to start the rehabilitation early, we started to use intermittent CSF drainage from June 2002. We treated 45 patients of ruptured cerebral aneurysm over 75 years of age from January 2000. We compared 2 groups: a continuous CSF drainage group and an intermittent CSF drainage group. We compared the frequency of symptomatic vasospasm, hydrocephalus and Glasgow outcome scale (GOS) score of 37 patients who underwent intermittent CSF drainage with those of 8 patients who underwent continuous CSF drainage. There was no difference of frequency of symptomatic vasospasm and hydrocephalus between the 2 groups; the GOS score of intermittent CSF drainage group was better than that of the continuous CSF drainage group. Intermittent CSF drainage prevented the complications of aged patients and was considered to effectively improve prognosis.
日本脳卒中の外科学会の論文
2008-03-31