重度颅脑损伤后采用低温疗法治疗持续性颅内高压可能会诱发晚期脑血管痉挛。
Persistent intracranial hypertension treated by hypothermic therapy after severe head injury might induce late-phase cerebral vasospasm.
作者信息
Yanagawa Youichi, Sakamoto Toshihisa, Okada Yoshiaki
机构信息
Department of Traumatology and Critical Care Medicine, National Defense Medical College, Saitama, Japan.
出版信息
J Trauma. 2007 Feb;62(2):287-91; discussion 291. doi: 10.1097/01.ta.0000223023.98182.d9.
BACKGROUND
Vasospasm caused by intracranial hypertension in head injury remains controversial.
METHODS
Between 1996 and 2004, we prospectively and consecutively performed conventional cerebral angiography for six patients with head injuries who showed persistent intracranial hypertension (over 20 mm Hg for longer than 5 days) despite performing various treatments for intracranial hypertension.
RESULTS
All subjects had a minor hemorrhage at admission, classified as Fisher group 2. Five of the six patients had angiographically confirmed vasospasm, and one of them later developed a cerebral infarction. Four of the five subjects who exhibited cerebral vasospasm had undergone hypothermic therapy to control the intracranial hypertension.
CONCLUSION
Our results suggest that persistent intracranial hypertension that is treated by hypothermic therapy may be related to late phase cerebral vasospasm.
背景
颅脑损伤中颅内高压引起的血管痉挛仍存在争议。
方法
1996年至2004年间，我们对6例颅脑损伤患者进行了前瞻性连续常规脑血管造影，这些患者尽管对颅内高压采取了各种治疗措施，但仍表现出持续性颅内高压（超过20 mmHg持续超过5天）。
结果
所有受试者入院时均有轻度出血，分类为Fisher 2级。6例患者中有5例经血管造影证实有血管痉挛，其中1例后来发生了脑梗死。表现出脑血管痉挛的5例受试者中有4例接受了低温疗法以控制颅内高压。
结论
我们的结果表明，通过低温疗法治疗的持续性颅内高压可能与晚期脑血管痉挛有关。
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