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动脉内注射维拉帕米治疗动脉瘤破裂所致急性蛛网膜下腔出血患者的脑血管痉挛:病例报告

Intra-arterial injection of verapamil in treatment of cerebral vasospasm in a patient with acute subarachnoid hemorrhage from an aneurysm: case report.

作者信息

Mikeladze K G, Éliava Sh Sh, Shekhtman O D, Lubnin A Iu, Tabasaranskiĭ T F, Iakovlev S B

出版信息

Zh Vopr Neirokhir Im N N Burdenko. 2013;77(4):57-60; discussion 60.

Abstract

Cerebral vasospasm is a major cause of cerebral ischemia and neurological deficits in patients after SAH from the aneurysm. According to angiorraphy cerebral vasospasm in acute rupture of an aneurysm is detected in 50-70% of cases, and the risk of ischemia on it's background is 19-46%. One of the new trends of treatment of cerebral vasospasm is the intra-arterial injection of calcium channel blockers. The article presents a case of selective intra-arterial injection of verapamil for the treatment of cerebral vasospasm in patient after severe subarachnoid and parenchymal hemorrhage of the internal carotid artery bifurcation aneurysm with a good clinical outcome.

摘要

脑血管痉挛是动脉瘤性蛛网膜下腔出血(SAH)患者发生脑缺血和神经功能缺损的主要原因。根据血管造影,动脉瘤急性破裂时,50%-70%的病例可检测到脑血管痉挛,在此背景下发生缺血的风险为19%-46%。脑血管痉挛治疗的新趋势之一是动脉内注射钙通道阻滞剂。本文介绍了1例选择性动脉内注射维拉帕米治疗颈内动脉分叉动脉瘤严重蛛网膜下腔和实质内出血后患者脑血管痉挛的病例,临床效果良好。

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