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[蛛网膜下腔出血所致血管痉挛血管成形术中的颈动脉夹层。多模态脑监测的应用]

[Carotid dissection during angioplasty for vasospasm induced by subarachnoid haemorrhage. The use of multimodal cerebral monitoring].

作者信息

Bordes J, Boret H, Prunet B, Montcriol A, Goutorbe P

机构信息

Département d'anesthésie-réanimation, HIA Sainte-Anne, 2 boulevard Sainte-Anne, Toulon, France.

出版信息

Ann Fr Anesth Reanim. 2009 Dec;28(12):1023-8. doi: 10.1016/j.annfar.2009.09.014.

Abstract

We report the case of a 54-year-old woman presenting subarachnoid haemorrhage. She experienced multiple vasospasms and treatment included triple-H (hypervolaemia, hypertension, and haemodilution) and endovascular therapies. Right internal carotid dissection complicated angioplasty of the right middle cerebral artery. Combined brain tissue partial pressure of oxygen monitoring and transcranial echo-Doppler could have facilitated early diagnosis. Despite successful revascularization of right internal carotid by stenting, this complication caused acute stroke with refractory intracranial hypertension.

摘要

我们报告了一例54岁女性蛛网膜下腔出血的病例。她经历了多次血管痉挛,治疗包括三H疗法(扩容、高血压和血液稀释)以及血管内治疗。右侧大脑中动脉血管成形术并发右侧颈内动脉夹层。联合脑组织氧分压监测和经颅超声多普勒检查可能有助于早期诊断。尽管通过支架置入成功实现了右侧颈内动脉再血管化,但该并发症导致了伴有难治性颅内高压的急性中风。

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