Kondziolka D, Bernstein M, Spiegel S M, ter Brugge K
Division of Neurosurgery, Toronto Western Hospital, University of Toronto, Ontario, Canada.
J Neurosurg. 1988 Oct;69(4):494-9. doi: 10.3171/jns.1988.69.4.0494.
The authors describe three cases of clinical cerebral ischemia associated with angiographic evidence of cerebral arterial luminal narrowing presenting 7, 14, and 52 weeks after subarachnoid hemorrhage (SAH) and aneurysm clipping. Delayed vasospasm, in its usual time setting 1 or 2 weeks after hemorrhage, did not occur symptomatically in these patients. No evidence for aneurysm clip migration or rebleed was present. All patients responded favorably to volume expansion and elevation of blood pressure. This unusual occurrence of a very delayed vasospasm may further the understanding of the vasospastic process. The symptomatic onset of arterial luminal narrowing months after SAH may suggest that a proliferative vasculopathy more accurately explains the observed vessel narrowing, rather than conventional active constriction of vascular smooth muscle.
作者描述了3例临床脑缺血病例，这些病例伴有脑动脉管腔狭窄的血管造影证据，分别在蛛网膜下腔出血（SAH）和动脉瘤夹闭术后7周、14周和52周出现。在这些患者中，未出现通常在出血后1或2周发生的迟发性血管痉挛的症状。没有证据表明动脉瘤夹移位或再出血。所有患者对扩容和血压升高反应良好。这种非常迟发性血管痉挛的不寻常发生情况可能会加深对血管痉挛过程的理解。SAH数月后动脉管腔狭窄的症状性发作可能表明，一种增殖性血管病变比传统的血管平滑肌主动收缩更能准确解释观察到的血管狭窄。
