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[1例合并主动脉缩窄的破裂脑动脉瘤]

[A case of ruptured cerebral aneurysm associated with coarctation of the aorta].

作者信息

Yonekawa Yuko, Nakahashi Yusuke, Mizuno Yusuke, Kamiya Yoshinori, Takeda Kouji, Goto Takahisa

机构信息

Department of Painclinic, NTT Medical Center Tokyo, Tokyo 141-8625.

出版信息

Masui. 2012 Mar;61(3):326-8.

Abstract

A 15-year-old boy with subarachnoid hemorrhage was planned for emergency cerebral aneurysm clipping under general anesthesia. He had different blood pressure between the upper limbs and we found coarctation of the aorta at left subclavian artery bifurcation in the preoperative angiography. To prevent re-rupture of cerebral aneurysm and ischemia of abdominal organs, we monitored arterial blood pressure in bilateral radial arteries and non-invasive blood pressure in the left thigh, and his blood pressure was maintained within 120-150 mmHg of systolic pressure in the right radial artery and 50-70 mmHg of mean arterial pressure in the left radial artery and the left thigh during general anesthesia. The preoperative period elapsed uneventfully and the patient was planned for repair of coarctation of the aorta after discharge.

摘要

一名15岁蛛网膜下腔出血男孩计划在全身麻醉下进行紧急脑动脉瘤夹闭术。他双上肢血压不同,术前血管造影发现主动脉在左锁骨下动脉分叉处缩窄。为防止脑动脉瘤再次破裂和腹部器官缺血,我们监测了双侧桡动脉的动脉血压以及左大腿的无创血压,全身麻醉期间其血压维持在右桡动脉收缩压120 - 150 mmHg、左桡动脉和左大腿平均动脉压50 - 70 mmHg范围内。术前阶段顺利度过,患者计划出院后进行主动脉缩窄修复术。

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