クモ膜下出血早期の意識障害の対策:-脳動脈瘤破裂後の内脳水腫を中心として-

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It is well recognized that the communicating hydrocephalus following the rupture of intracranial aneurysms is one of factors which causes the disturbance of consciousness. In this report we analyze the surgical experience with this complication and discuss the etiological factors. 1. The communication hydrocephalus following the rupture of intracranial aneurysms are divided into acute and chronic form. 2. Acute communicating hydrocephalus may develop within 24 hours after onset and the frepuency is about 10% (6 out of 66 cases). 3. Ventriculocranial index on carotid angiogram is the reliable prognostic measure of shunting procedures. 4. Intraventricular pressure is high in acute communicating hydrocephalus and becomes normal in chronic stage. 5. The incidence of chronic communicating hydrocephalus is about 10% (6 out of 66 cases). 6. There are two types of chronic communicating hydrocephalus. One developes from and another developes gradually after onset. 7. The intraventricular pressure of the former case is high in acute stage and the latter shows the intermittent high pressure lasting for 20-30 minutes. 8. Indication for shunting procedures should be determined by combination of clinical pictures, ventriculocranial index, findinge of cisternography and EEG. Our operative criteria are presented.
The Japanese Society on Surgery for Cerebral Strokeの論文