22. 破裂脳動脈瘤急性期の治療:-我々の手術法-

概要

論文の詳細を見る
In our intracranial operation of ruptured cerebral aneurysms in acute stage, at first, continuous ventricle drainage was done in almost all cases. After then brain was slacked and operation became easier. This drainage was used postoperatively for controlling intracranial pressure. The design of craniotomy was chosen by CT findings. From our study subarachnoid clots which was shown as high density area over sixty in CT number causes symptomatic vasospasm. Bifrontal craniotomy was performed so frequently in acute stage operation to evacuate subarachnoid clots bilaterally which had high CT number over sixty. During evacuation of subarachnoid clots 10 to 100 mMol NaNO<SUB>2</SUB> was used for prevention of postoperative vasospasm. In desection of aneurysm temporary clipping of parent artery under administration of 20% mannitol or"Sendai cocktail"was used in all cases for prevention of premature rupture of aneurysm. In these two years eighty-eight cases which had ruptured aneurysms in anterior circle of Willis were operated on in acute stage within 48 hours after the onset. Operative results were followed two months after the operation. Seventy-three cases (82.9%) were able to work, in seven cases (8.0%) rehabilitation was necessary and eight cases (9.1%) were died.
The Japanese Society on Surgery for Cerebral Strokeの論文