Cusick J F, Ho K C, Schamberg J F
J Neurosurg. 1987 May;66(5):775-8. doi: 10.3171/jns.1987.66.5.0775.
Subarachnoid hemorrhage is a frequent finding in patients who have incurred neurological complications following chymopapain chemonucleolysis, but the basis for this occurrence remains controversial. The authors report the clinical and postmortem findings in a 42-year-old man who died 5 days after chemonucleolysis at the L4-5 and L5-S1 disc spaces. The predominant histological abnormality was a severe inflammatory arteritis of a medium-sized artery at the upper cervical level with disruption of the vessel wall. The potential causative role of chymopapain in this situation and the correlation of a vascular basis for many of the complications found after inadvertent intrathecal chymopapain injector are discussed.
蛛网膜下腔出血是木瓜凝乳蛋白酶化学髓核溶解术后发生神经并发症患者中的常见表现，但这种情况的发生原因仍存在争议。作者报告了一名42岁男性患者的临床和尸检结果，该患者在L4-5和L5-S1椎间盘间隙进行化学髓核溶解术后5天死亡。主要的组织学异常是颈上段一条中等大小动脉的严重炎症性动脉炎，伴有血管壁破裂。本文讨论了木瓜凝乳蛋白酶在这种情况下的潜在致病作用，以及意外鞘内注射木瓜凝乳蛋白酶后发现的许多并发症的血管基础相关性。
