动脉内输注盐酸法舒地尔治疗创伤后脑血管痉挛。

Intra-arterial infusion of fasudil hydrochloride to treat post-traumatic cerebral vasospasm.

作者信息

Murakami Tomoaki, Kajikawa Ryuichiro, Nakamura Hajime, Nishida Takeshi, Yoshimura Kazuhiro, Yoshihara Tomoyuki, Tsuruzono Koichiro, Wakayama Akatsuki, Kishima Haruhiko

机构信息

Department of Neurosurgery Osaka Neurological Institute Toyonaka City Japan.

Department of Neurosurgery Osaka University Graduate School of Medicine Suita Japan.

出版信息

Acute Med Surg. 2019 Apr 19;6(4):392-395. doi: 10.1002/ams2.420. eCollection 2019 Oct.

DOI:10.1002/ams2.420

PMID:31592086

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6773654/

Abstract

BACKGROUND

The effect of intra-arterial infusion of fasudil hydrochloride in patients with post-traumatic cerebral vasospasm remains unclear. Here we report a case of intra-arterial infusion of fasudil hydrochloride for post-traumatic cerebral vasospasm.

CASE PRESENTATION

A 47-year-old man was transferred to our hospital with a fractured skull and traumatic subarachnoid hemorrhage. As rhinorrhea of cerebrospinal fluid had not improved, repair surgery was carried out on day 4. Aphasia appeared on day 13. Magnetic resonance imaging and angiography showed an ischemic region in the left temporal lobe and vasospasm of the left middle cerebral artery. We immediately carried out angiography and diagnosed severe vasospasm of the M1 region of the left middle cerebral artery. After placing a microcatheter into the proximal middle cerebral artery, we injected fasudil hydrochloride intra-arterially. Vasospasm improved and aphasia resolved.

CONCLUSION

In this case, intra-arterial infusion of fasudil hydrochloride was effective against post-traumatic cerebral vasospasm.

摘要

背景

盐酸法舒地尔动脉内输注对创伤后脑血管痉挛患者的疗效仍不明确。在此，我们报告一例盐酸法舒地尔动脉内输注治疗创伤后脑血管痉挛的病例。

病例介绍

一名47岁男性因颅骨骨折和创伤性蛛网膜下腔出血被转至我院。由于脑脊液鼻漏未改善，于第4天进行了修复手术。第13天出现失语。磁共振成像和血管造影显示左颞叶有缺血区，左大脑中动脉痉挛。我们立即进行血管造影，诊断为左大脑中动脉M1段严重痉挛。在将微导管置入大脑中动脉近端后，我们经动脉注射了盐酸法舒地尔。痉挛得到改善，失语症状消失。