66. 脳血管攣縮に起因する脳虚血の予防対策

概要

論文の詳細を見る
Delayed cerebral vasospasm is an important determinant of the clinical outcome after subarachnoid hemorrhage. We have reported the fact that the arteries in the stage of delayed vasospasm shows not only the organic change of the vascular wall but also they have various degree of thrombi in the lumen. These thrombus supposed to be responsible to the development of clinical symptoms caused by vasospasm in addition to the stenosis of vascular lumen. In this respect, we expect MDS (dextran sulfate) should play effective role in diminishing the clinical aggaravation due to delayed vasospasm. The prognosis of the SAH patients treated by MDS became better compared to the previous non-treated cases. In the highly predicting cases of symptomatic angiospasm, MDS regimen is the choice immediately after neck clipping of aneurysm. If this regimen is combined with plasma expander therapy or induced hypertension therapy, mortality will turn better.
The Japanese Society on Surgery for Cerebral Strokeの論文