39. 破裂脳動脈瘤直接手術と血流時遮断

概要

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We have reported that the preoperative mannitol administration under normothermia and normotension was effective to protect the ischemic damage. Recently, using the "canine model of complete ischemic brain regulated with a perfusion method", the effects of various agents, which are thought as free radical scavenger, were investigated. More favorable effects were found when the combined administration of mannitol, vit. E and dexamethasone was made as compared with single administration of the each drug. This experimental results are thought to indicate that this new combination therapy may be useful in the clinical cases.<BR>In this study, based on 81 aneurysm cases, which received defenitive aneurysm surgery by utilizing temporary clipping and preoperative administration of combined drugs, 20% mannitol 500 ml containing vit. E 300 mg and dexamethasone 50 mg, the occlusion time, the occlusion sites of main arteries and the complication due to temporary clipping were examined. There was no case which showed the sequelae apparently due to temporary occlusion.
The Japanese Society on Surgery for Cerebral Strokeの論文