Completed strokeに対する手術適応決定の一方法:-高圧酸素療法-

概要

論文の詳細を見る
Extrcranial-Intracranial (EC-IC) bypass surgery is now an established procedure as a treatment for ischemic strokes. However, there have been some controversies over the efficacy of this surgery for patients with completed stroke. One of the problems is difficulty to select proper candidates. The authors have found that the Hyperbaric Oxygenation (HO) is a useful technique to determine candidates for bypass surgery. Twelve patients with completed strokes underwent HO for 70 min. per day. Neurological conditions and EEG were evaluated after twenty times of HO. Nine patients showed significant improvement and were considered as responders to HO. Three patients were non-responders. EC-IC bypass was performed for all of these patients. Five out of nine responders to HO showed consistent improvement after STA-MCA anastomosis, while three non-responders to HO remained unchanged after surgery. Our results indicate that some patients with completed stroke have benefit from bypass operation, and that the candidates for surgery could be selected by HO. We assume that there are two kinds of pathological conditions in completed stroke; one is totally damaged brain (irreversible state) and the other is partially damaged brain (reversible state). HO is not only useful as a treatment of stroke patients but also a valuable method to detect ischemic brain in reversible state.
The Japanese Society on Surgery for Cerebral Strokeの論文