脳虚血性病態に対するinduced hypertensionの応用

概要

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It has been our experiences to observe increased cerebral blood flow in unanesthetized cats in accordance with elevated systemic blood pressure following intravenous administration of norepinephrine. Based on this experiences, drug-induced hypertension was used in treatment of ischemic condition or in order to know the indication of by-pass surgery. <BR>Material and method. Systemic hypertension was induced by norepinephrine at the dose of 10-15mg in 500ml lactated Ringer solution, which was dripped at the speed of 40-100ml/hr, to keep blood pressure above the critical level, usually between 160-200mmHg. Accumulated cases are 12, including 6 patients with vasospasm in postoperative course of aneurysmal surgery, and 6 others with various organic stenotic or occlusive condition. <BR>Results: 1) All of 6 cases with postoperative vasospasm showed improvement in neurological status by induced hypertension. 2) Vasospasm of the artery was immediately improved to normal caliber in one case by induction of hypertension during angiography. EEG was also showed improvement in some. 3) In ischemic condition other than vasospasm, STA-MCA anastomosis was performed only when induced hypertension caused favorable effects. This seems to be reliable measure to predict the effect of by-pass surgery.
The Japanese Society on Surgery for Cerebral Strokeの論文