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Neurological Surgery No Shinkei Geka Volume 22, Issue 1 （January 1994）

Neurological Surgery 脳神経外科 22巻1号（1994年1月発行）

Japanese English

研究

クモ膜下出血後の症候性脳血管攣縮に対する大量ステロイドの使用経験—21症例の臨床的検討 The Experiences of a Large Amount of Steroid Therapy for Symptomatic Vasospasm after Subarachnoid Hemorrhage:Clinical analysis of 21 cases 安川浩司 ¹ , 上條幸弘 ¹ , 百瀬玄機 ¹ , 小林茂 ¹ , 黒柳隆幸 ² , 師田信人 ² , 鵜木隆 ² Kouzi YASUKAWA ¹ , Yukihiro KAMIJOU ¹ , Genki MOMOSE ¹ , Shigeru KOBAYASHI ¹ , Takayuki KUROYANAGI ² , Nobuhito MOROTA ² , Takashi UNOKI ² ¹小林脳神経外科・神経内科病院 ²信州大学脳神経外科 ¹Kobayashi Neurosurgical and Neurological Hospital ²Department of Neurosurgery, Shinsyu University School of Medicine キーワード： Subarachnoid hemorrhage , Symptomatic vasospasm , Steroid therapy Keyword: Subarachnoid hemorrhage , Symptomatic vasospasm , Steroid therapy pp.17-22

発行日 1994年1月10日 Published Date 1994/1/10

DOI https://doi.org/10.11477/mf.1436900765

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Abstract 文献概要
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I．はじめに

　クモ膜下出血後の脳血管攣縮は，脳神経外科が著しい進歩をとげている現在でも重要な合併症であり，その予防及び発症後の治療については様々な方法が試みられている．今回われわれはクモ膜下出血後に症候性脳血管攣縮を呈した21例に対し，大量ステロイドの使用を試みた．ここでは，その結果について臨床的検討と共に文献的考察を加え，報告したいと思う．

Among 48 cases of subarachnoid hemorrhage, 21 cases (43.8%) showed symptomatic vasospasm. We attempted treatment, using a large amount of steroid therapy for them in accord with our own protocol.

In the 21 cases who received steroid therapy for symptomatic vasospasm, 18 cases (85.7%) showed im-provement of their symptoms. This was especially evi-dent in about 8 cases where the steroid effect was re-markable. There was a serious side effect, GI—tract bleeding, in one case. Althoug the effect of the steroid therapy was evident for slight or moderate spasmcases, 5 severe spasm cases responded poorly. We con-cluded that a large amount of steroid therapy was effective for slight or moderate symptomatic vasospasm cases, and that in severe ones possibly another therapy combined with steroid therapy would be necessary.