Flynn E P
Neuroscience Intensive Care Unit, Yale New Haven Hospital, Connecticut 06504.
J Neurosci Nurs. 1989 Dec;21(6):348-52. doi: 10.1097/01376517-198912000-00004.
Cerebral vasospasm is currently recognized as a major cause of morbidity and mortality in patients surviving subarachnoid hemorrhage due to intracranial aneurysmal rupture. Effective management and possible prevention of the ischemic sequelae of vasospasm can occur if the clinical syndrome of vasospasm is detected in its earliest stages. This article acquaints the reader with the significant risk factors associated with development of vasospasm, the temporal profile of occurrence and the signs and symptoms of the clinical syndrome. A brief overview of some popular theories of vasospasm etiology and pathogenesis is presented. Additionally, a protocol for detection is provided incorporating the knowledge of population at risk, temporal profile and signs and symptoms of cerebral vasospasm.
目前,脑血管痉挛被认为是颅内动脉瘤破裂所致蛛网膜下腔出血存活患者发病和死亡的主要原因。如果能在脑血管痉挛临床综合征的最早阶段检测到它,就可以有效地控制并有可能预防其缺血性后遗症。本文让读者了解与脑血管痉挛发生相关的重要危险因素、发生的时间规律以及临床综合征的体征和症状。还简要概述了一些关于脑血管痉挛病因和发病机制的流行理论。此外,还提供了一个检测方案,其中纳入了对高危人群、脑血管痉挛发生的时间规律以及体征和症状的认识。