急性期脳動脈瘤患者における急性期手術までの全身管理の問題点:-入院24時間以内の再破裂症例の検討から-

概要

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The authors studied the aneurysmal re-bleeding in 279 patients with ruptured intracranial aneurysm who were admitted within 72 hours after last subarachnoid hemorrhage (SAH), and discussed how to manage the patients in acute stage. The following results were obtained. 1) During first 24-hour hospitalization, re-bleeding occurred in 29 cases (10.4%). 2) The time interval from last SAH was a significant risk factor for re-bleeding. The cases, admitted within 3 hours from last SAH, were easily re-bled (17.6%). Sex, age, site of ruptured aneurysm, number of SAH and surgical grade were not risk factors for re-bleeding. 3) The mortality associated with re-bleeding was 69.0%. Only 10 cases were operated. 4) Re-bleeding took place usually under uncontrolled hypertension and/or after recurrent vomiting and careless positioning. 5) For preventing re-bleeding of aneurysm in acute stage, the patient is necessary to be controlled blood pressure and to be taken sedativa and antiemetic.
The Japanese Society on Surgery for Cerebral Strokeの論文