われわれの脳血管攣縮の分類と予後との関係

概要

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The authors analyzed 147 cerebral angiograms of 56 cases with ruptured aneurysms which were operated on within 3 days after SAH and showed vasospasm postoperatively. Characteristics of postoperative vasospasm and the correlation between vasospasm, and patients' prognosis, cerebral blood flow and infarction on CT scan were examined. Up to now, we have used the type of vasospasm after Saito in which angiographical findings were morphologically classified. In this study, we have tried a quantitative measurement of the extention and degree of vasospasm. <BR>The results were as follows: 1) Compared with preoperative vasospasm, postoperative vasospasm occurred in more distal branches of cerebral arteries, namely, in M 2-3 portion of the middle cerebral artery or A 2-3 portion of the anterior cerebral artery. This may be mainly due to the fact that the cisternal clots near the proximal portion of cerebral arteries could be removed by early operation and continuous cisternal irrigation postoperatively. 2) Distal and extensive type of vasospasm exerted more crucial influences upon patients' prognosis, CBF and formation of cerebral infarction than proximal type of postoperative vasospasm. <BR>Quantitative estimation of vasospasm was not yet satisfactory and its technical limits and methodological aspects were also disussed.
The Japanese Society on Surgery for Cerebral Strokeの論文