Masamura Tomona, Kurita Akihide, Yamamoto Takashi, Yamada Keisuke, Yamamoto Ken
Masui. 2015 Apr;64(4):426-9.
A patient developed persistent disturbance of consciousness after uneventful clipping of an unruptured cerebral aneurysm under general anesthesia. Pseudohypoxic brain swelling (PHBS) was suspected because computerized tomography (CT) and magnetic resonance imaging (MRI) revealed diffuse brain swelling, especially in the bilateral basal ganglia and thalami. Steroid pulse therapy in addition to antiedematous drugs and anticonvulsant improved the consciousness. Anesthesiologists should pay attention to PHBS in a case of persistent disturbance of consciousness after uneventful craniotomy.
一名患者在全身麻醉下对未破裂的脑动脉瘤进行顺利夹闭术后出现持续意识障碍。由于计算机断层扫描（CT）和磁共振成像（MRI）显示弥漫性脑肿胀，尤其是双侧基底节和丘脑，怀疑为假性缺氧性脑肿胀（PHBS）。除使用抗水肿药物和抗惊厥药物外，给予类固醇脉冲治疗后意识有所改善。对于开颅手术顺利但术后出现持续意识障碍的病例，麻醉医生应注意PHBS。
