62. 脳血管攣縮の治療における合併症

概要

論文の詳細を見る
Raising blood pressure is often recommended as a form of initial treatment in cases of cerebral ischemia following vasospasm, but sometimes the effect of increased perfusion pressure may further deteriorate brain damage by increasing cerebral edema or producing hemorrhagic infarction.<BR>Ninety-nine acute cases of ruptured cerebral aneurysms were analysed in this report in order to investigate whether development of these complications of induced hypertension could be predicted from the data obtained by clinical observations.<BR>Forty six cases showed ischemic symptoms of delayed onset, and 31 cases were treated by induced hypertension using dopamine for average of 3.6 days. Seven cases out of 31 showed progressive enlargement of low density areas in CT and one of them developed hemorrhagic infarction. None of the clinical parameters in these cases, such as age, level of blood pressure, neurological condition or the interval between SAH and onset of ischemic symptoms etc., were significantly different from the other uncomplicated cases.<BR>It was concluded that more parameters concerning hemodynamic aspects should be required for prediction of these complications of induced hypertension.
The Japanese Society on Surgery for Cerebral Strokeの論文