Messeter K, Brandt L, Ljunggren B, Svendgaard N A, Algotsson L, Romner B, Ryding E
Neurosurgery. 1987 Apr;20(4):548-53. doi: 10.1227/00006123-198704000-00007.
Mean hemispheric cerebral blood flow (CBF) was studied after the intravenous administration of xenon-133 in 20 anesthetized patients with aneurysmal subarachnoid hemorrhage. Before early aneurysm operation, repeated CBF measurements were made to evaluate the cerebral vascular reactivity to controlled hyperventilation. Thirteen individuals received intravenous treatment with the calcium channel blocker nimodipine, whereas the other seven patients did not receive such specific antiischemic treatment. Five of the latter patients had an impaired CO2 response, and three showed delayed ischemic deterioration (DID), whereas none of the seven nimodipine-treated patients with impaired CO2 response showed DID. One nimodipine-treated patient with a preserved CO2 response, in whom operation was complicated, developed DID. The observed findings indicate that DID after uncomplicated early aneurysm operation may be associated with an early disturbance of cerebral vasoreactivity. Treatment with nimodipine may counteract the development of DID in patients with an impaired CBF CO2 response.
对20例麻醉状态下的动脉瘤性蛛网膜下腔出血患者静脉注射氙-133后，研究了平均半球脑血流量（CBF）。在早期动脉瘤手术前，反复进行CBF测量，以评估脑血管对控制性过度通气的反应性。13例患者接受了钙通道阻滞剂尼莫地平的静脉治疗，而其他7例患者未接受这种特异性抗缺血治疗。后一组患者中有5例二氧化碳反应受损，3例出现迟发性缺血性恶化（DID），而7例接受尼莫地平治疗且二氧化碳反应受损的患者均未出现DID。1例接受尼莫地平治疗且二氧化碳反应正常但手术复杂的患者发生了DID。观察结果表明，早期动脉瘤手术无并发症后的DID可能与脑血管反应性的早期紊乱有关。尼莫地平治疗可能会抵消CBF二氧化碳反应受损患者DID的发生。
