造影剤漏出を認めた高血圧性脳出血症例の検討

概要

論文の詳細を見る
Twenty cases with extravasation of contrast medium in the hypertensive intracerebral hemorrhage were presented, out of which 18 cases were diagnosed as the putaminal and the others the thalamic hemorrhage. The leakage of contrast material was demonstrated on the cerebral angiography which was performed within 8 hours of the apoplectic onset. The ruptured vessel was visualized angiographically to be the lateral branch of the lenticulostriate artery in the putaminal hemorrhage and the thalamoperforating artery in the thalamic hemorrhage. The average distances from the origin of the perforating arteries to the site of extravasation were 26.3mm and 26.0mm respectively on angiography. Systemic blood pressure on admission increased to 212±8mmHg in the cases with these findings, in contrast with 177±5mmHg in the small putaminal hemorrhage. It appears that the systemic high blood pressure at the acute phase might be associated with the sustained leakage of the contrast medium. These findings indicate a very grave prognosis, however the urgent surgical intervention may offer a chance of recovery in about half of these patients.
The Japanese Society on Surgery for Cerebral Strokeの論文