68. 破裂脳動脈瘤の手術成績と脳動脈攣縮との関連について

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Cerebral vasospasm has been considered to be one of the important factors which affect the eventual outcome of patients undergoing operation for ruptured aneurysms. The follow-up results of operation of 62 cases with ruptured aneurysm clearly showed that the presence of vasospasm unfavorably influenced the surgical outcome. Among 35 cases with spasm, only 5 patients had an excellent result and 14 good, while all 27 patients without spasm showed excellent (18) or good (9) result. Spasm was observed in 16 (76.2%) of 21 patients undergoing early operation (within 72 hours after hemorrhage), while it was observed in 19 (46.3%) of 41 patients undergoing late operation (8th day or later after hemorrhage). Therefore, the outcome was better in the later operation group. However, among the cases with spasm, there was no significant difference in the eventual outcome between the early and late operation groups. In 18 patients calcium antagonist YC-93 (nicardipine hydrochloride) was intravenously administered during pre- and postoperative periods from the day of admission. YC-93 did not prevent or inhibit the development of vasospasm, but the surgical outcome was better in the group with YC-93 than without it.<BR>The present data showed that the presence of cerebral vasospasm unfavorably influence the outcome of operation for ruptured aneurysm, and that YC-93 did not inhibit vasospasm, but the surgical outcome was better in the group with YC-93.
The Japanese Society on Surgery for Cerebral Strokeの論文

68. 破裂脳動脈瘤の手術成績と脳動脈攣縮との関連について

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