Takabatake Y, Yamashita J, Higashi S, Yamashima T, Yamamoto Y
Department of Neurosurgery, Kanazawa University, School of Medicine, Japan.
Neurochirurgia (Stuttg). 1992 Mar;35(2):54-6. doi: 10.1055/s-2008-1052246.
Delayed cerebral vasospasm associated with marked elevation of serum creatine phosphokinase (CPK) is reported. A 21-year-old man with unruptured arteriovenous malformation (AVM) in the left temporal lobe developed postoperative symptomatic vasospasm lasting for 2 weeks. A postoperative computerized tomography scan showed intraventricular hematoma without subarachnoid hemorrhage in the basal cistern. On day 5 after surgery, the patient developed motor aphasia due to marked vasospasm around the bifurcation of internal carotid artery. On day 7 and 8, serum CPK was elevated as high as 1175 and 1376 IU/l, respectively. On day 35 when he had completely recovered from cerebral vasospasm both clinically and angiographically, the level of CPK was normalized. The causative factors of symptomatic cerebral vasospasm following surgery of unruptured AVM associated with CPK elevation are discussed.
据报道，延迟性脑血管痉挛与血清肌酸磷酸激酶（CPK）显著升高有关。一名21岁男性，左颞叶未破裂动静脉畸形（AVM），术后出现症状性血管痉挛，持续2周。术后计算机断层扫描显示脑室内血肿，基底池无蛛网膜下腔出血。术后第5天，患者因颈内动脉分叉处明显血管痉挛出现运动性失语。术后第7天和第8天，血清CPK分别升高至1175和1376 IU/l。术后第35天，患者临床和血管造影均已从脑血管痉挛中完全恢复，CPK水平恢复正常。本文讨论了未破裂AVM手术后出现症状性脑血管痉挛并伴有CPK升高的病因。
