脳動脈瘤症例における脳循環の検討

概要

論文の詳細を見る
In order to get a useful parameter to predict the haemodynamic changes of subarachnoid haemorrhage, single photon emission computed tomography (SPECT) findings of 100 aneurysmal patients were investigated before and after the operations. In 26 patients the measurements of mean cerebral blood flow (mCBF) were carried out by means of the Patlak's method. Results were as follows: 1) Over all appearance rate of low perfusion area (LPA) in SPECT was 85%. The appearance rate diminished chronologically to 56% around forty days after the operations. The LPA was corresponded to the craniectomised areas and would have been caused by brain retractions during the operative procedures. The LPA which was already recognized in the acute stage of subarachnoid hemorrhage had close correlation with the occurrence of symptomatic cerebral vasospasm in the postoperative clinical course. 2) Repeated CBF measurements revealed that mCBF of operative site was decreased transiently around 6 days after the operation. Thereafter the mCBF turned to increase in 20 and 45 days. The transient decreasing of mCBF after the operation was considered to be rather favorable prognostic factor to expect good Glasgow Outcome Scale. On the other hand, hyperperfusion of mCBF without any chronological fluctuation indicated poor prognosis, suggesting luxury perfusion syndrome.
東京女子医科大学の論文
1998-08-25