Yabumoto M, Kuriyama T, Iwamoto M, Kinoshita T
Neurosurgery. 1986 Aug;19(2):300-4. doi: 10.1227/00006123-198608000-00025.
A case of ruptured distal anterior cerebral artery aneurysm associated with neurogenic pulmonary edema is presented. It is suggested that this association should not be accepted as a "taboo" for radical intervention followed by a proper management of ventilation with positive end-expiratory pressure to maintain the anesthetic condition. Cardiorespiratory control is essential in cases of pulmonary edema with ruptured aneurysm. Decompression and evacuation of blood clot surrounding the hypothalamus could subdue the hyperadrenosympathetic discharge that may cause neurogenic pulmonary edema.
本文报告1例伴有神经源性肺水肿的大脑前动脉远端动脉瘤破裂病例。建议不应将这种关联视为根治性干预的“禁忌”，而应在适当管理呼气末正压通气以维持麻醉状态的情况下进行根治性干预。对于动脉瘤破裂并发肺水肿的病例，心肺控制至关重要。下丘脑周围血凝块的减压和清除可抑制可能导致神经源性肺水肿的肾上腺交感神经过度放电。
