くも膜下出血急性期の病態—Multimodality Evoked Potentials（MEPs）とTranscranial Doppler（TCD）による検討

Brain Function and Blood Flow Velocity in the Middle Cerebral Artery in Subarachnoid Hemorrhage: Evaluation with multimodality evoked potentials (MEPs) and transcranial doppler (TCD) ultrasound

I．はじめに

　破裂脳動脈瘤によるくも膜下出血（SAH）急性期の病態，とくに脳機能や脳循環障害の程度は治療方針の決定や患者の予後を判定する上で極めて重要である．これらは通常，患者の神経症状のほかCTや脳血管写上の所見などから判定されるが，ベットサイドで簡便に利用しうる検査法は少ない．

　今回著者らはSAH急性期例において，Multimodality Evoked Potentials（MEPs）およびTranscranialDoppler（TCD）法^1）による中大脳動脈血流速度（MCAFV）を指標として脳機能や脳循環状態の経時的観察を行い，本症急性期の病態について検討したので報告する．

Brain dysfunction and blood flow velocity changes in the middle cerebral artery (MCAFV) were studied in 59 patients with ruptured cerebral aneurysms presenting subarachnoid hemorrhage. Brain function and blood flow velocity were evaluated by multimodality evoked potentials (MEPs) consisting of ABR, SEP and VEP as reported, and transcranial Doppler (TCD) ultrasound. The abnormality on MEPs were graded into 4 grades. Nearly normal, mildly abnormal, moderately abnormal and severely abnormal.