破裂脳動脈瘤223例の解析—特に再破裂予防の観点から

Analysis of 223 Cases of Intracranial Aneurysms:With special reference to re-rupture of the intracranial aneurysms

I．はじめに

　脳動脈瘤に対する頭蓋内直達手術の時期に関して，脳血管攣縮^{25,31,34,44）}の観点からみた場合にはほぼ結論に達したものと思われるが，総括的にはいまだしである．

　今回われわれは脳動脈瘤の再破裂予防という観点から過去の症例を検討し，多少の知見を得たので報告した．

Reviewing 223 cases of intracranial ruptured anureysmsincluding 46 cases of re-ruptured aneurysms, the followingresults were obtained.

1) The outcome of the re-rupture aneurysms was moremiserable than that of the first rupture. Even low gradecases (Hunt and Hess O-II) of re-rupture showed no betteroutcome than high grade cases (Hunt and Hess IV) of firstrupture.

2) Re-rupture most often occurred on the 12th (11.6±6.7) day after the first attack of the subarachnoid hemor-rhage.

Re-rupture more often occurred in the vertebrobasilarsystem.