雑誌文献を検索します。書籍を検索する際には「書籍検索」を選択してください。

検索

書誌情報 詳細検索 by 医中誌

Japanese

Time-related Changes in the Cerebral Blood Flow in Subarachnoid Hemorrhage due to Ruptured Cerebral Aneurysm Tadaharu FUKUDA 1 , Masamichi HASUE 1 , Meishyu Ko 1 , Kouichi HASEGAWA 1 , Tatsuya NAKAMURA 1 , Tetsurou MIWA 2 1Department of Neurosurgery, Hachiouji Medical Center 2Department of Neurosurgery, Tokyo Medical Colledge Keyword: Subarachnoid hemorrhage , Ruptured intracranial aneurysms , Delayed ischemic neurological deficit , Cerebral blood flow pp.339-347
Published Date 1992/4/10
DOI https://doi.org/10.11477/mf.1436900428
  • Abstract
  • Look Inside

Cerebral blood flow (CBF) was determined by the 123I-IMP SPECT reference sample method in 39 pa-tients with subarachnoid hemorrhage (SAH) clue to ruptured cerebral aneurysm. They were examined according to the time lapse after onset, severity, CT findings, and prognosis. These 39 patients were admit-ted to our medical center within 36 hours after the onset, and SAH and ruptured aneurysm were dia-gnosed by CT scan and angiography, respectively. Pa-tients with intraventricular hemorrhage, intracerebral hematoma, and other severe complications were ex-cluded. The stage of SAH was divided into three, by designating the clay of onset as clay 0: clay 0-4 as the acute stage, day 5-20 as the subacute stage, and clay 21 and after that as the chronic stage. Acute stage surgery was conducted within 48 hours after the onset on prin-ciple. Hyperclynamic therapy and cisternal drainage were conducted in severe case of SAH. The prognosis was evaluated with Glasgow outcome scale (GOS). The average CBF was 33.39, 29.44, and 33.15 in the acute, subacute, and chronic stages, respectively. These are values lower than the reference sample value, 43.39 (ml/100g/min) . Only a small number of cases, how-ever, revealed vasospasm by angiography conducted in the acute stage. There was a correlation between the CT severity in the acute stage and the decrease in CBF. In the group with low density area (LDA) on CT clue to delayed cerebral ischemia in the subacute stage, the average CBF was 28.28 and 23.95 in the acute and subacute stages, respectively. These values were signifi-cantly lower than 35.97 and 32.45, respectively, in the group without LDA. CBF decreased by 0.79 in the group with cisternal drainage from the acute stage to the subacute stage, which is smaller than the decrease of 7.15 in the group without drainage. In the cases in which ventricular-peritoneal shunt was conducted for hydrocepharus in the chronic stage, increased CBF was observed after surgery. CBF of the group with good re-covery achieved by GUS was higher both in the acute and subacute stages than that found in the severely dis-abled cases and cases which resulted in death. Prog-nosis was better in the group with acute CBI.' of over 30 than the group with that of less than 30. Time re-lated determination of CBF in SAH was useful for the evaluation of the condition of SAH, selection of the therapeutic methods, and estimation of the prognosis.


Copyright © 1992, Igaku-Shoin Ltd. All rights reserved.

基本情報

電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

関連文献

もっと見る

文献を共有