CT上くも膜下腔高吸収域と脳血管攣縮発現に関する検討:-特にその治療との関係-

概要

論文の詳細を見る
Up to now, it has been accepted that subarachnoid blood and/or products play an important role in cerebral vasospasm after aneurysmal subarachnoid hemorrhage. The purpose of this study is to evaluate clot volume of subarachnoid hemorrhage by CT scans as exactly as possible. On a CT scan, if the total subarachnoid blood is considered as a mass (=volume x density), the amount is calculated as a clot score (=cts) which consists of the thickness, density (CT number) and localization, i. e. cts's in our method were measured on six cisterns and four points fissures, and one cistern or one fissure was given respectively one to three points in proportion to the degree of density and thickness as measured by CT scan. Total maximum cts points were thirty. Conversely, cerebral vasospasm has been assessed and graded by angiography, based on the reduction rate in the caliber of the major arteries. During the past 6 years, 68 of 271 patients with aneurysmal subarachnoid hemorrhage who had undergone serial CT scan and angiography after the ictus, were made available for this study. Among these cases, the cts was compared with the incidence of angiographic vasospasm and the effects by various treatments against cerebral vasospasm. Also, in five cases, RI cisternography was performed by means of lumbar puncture from Day 3 to 8 and cerebro-spinal fluid (CSF) dynamics were examined. Consequently, 1 ) our method resulted in a good correlation between the amount of blood and the severity of angiographic vasospasm in spite of both early and delayed surgery for ruptured aneurysms, 2) in the early stage after aneurysmal subarachnoid hemorrhage, CSF seldom circulated smoothly, and 3) continuous cisternal drainage (CCD) was the most effective treatment of all against cerebral vasospasm. It was suggested that applying cts to the parameter of a cerebral vasospasm, early surgery with extensive removal of the hematoma, and then, CCD in abnormal CSF dynamics were effective in preventing cerebral vasospasm.
The Japanese Society on Surgery for Cerebral Strokeの論文

CT上くも膜下腔高吸収域と脳血管攣縮発現に関する検討:-特にその治療との関係-

スポンサーリンク

概要

著者

関連論文

スポンサーリンク