椎骨動脈系虚血性脳血管障害-その手術適応判定のための自然経過に対する臨床的検討-
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概要
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Fifty five patients of ischemic cerebrovascular disease in the vertebrobasilar system were studied. On the angiographic examination, 7 patients were normal, 13 patients were only sclerotic and other 35 patient were positive Angiographic findings of these patients were as Table 2. Vertebral lesions were the most and lesions of posterior inferior cerebellar artery were the second.<BR>The grades of recovery were classified in 4 ADL grades. It was noted that 37 patients out of 51 were recovered to full activity (ADL-1) or to daily life for oneself (ADL-2). 7 patients were required help in daily life (ADL-3) and patients were restricted in bed all day long (ADL-4). All patients except one in ADL 3·4 groups had hemiplegia, blindness and dementia because of complicated supratentorial ischemic lesions. Ataxia was not the major residual deficit. But in one patient who had the bilateral cerebellar ischemic lesions (Rt-PICA occlusion and Lt-SCA occlusion) ataxia was the major residual deficit. 2 patients who had a basilar artery occlusion were died.<BR>From these angiographic and follow up review, ADL of ischemic cerebrovascular disease in vertebrobasilar system was relative good. On the other hand, occipital to posterior inferior cerebellar artery bypass surgery was indicated to prevent the major stroke for patients who had occlusive lesions of vertebral artery complicating TIAs, RIND or progressing deficits, not altered by anticoagulation therapy.
- The Japanese Society on Surgery for Cerebral Strokeの論文