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破裂性前交通动脉瘤直接手术后临床体征、计算机断层扫描及脑电图的比较研究——第一部分:轻度精神症状病例分析

[A comparative study of clinical signs, computed tomography, and electroencephalography after direct operation of ruptured anterior communicating aneurysms--Part I: Analysis of the cases with mental signs of mild degree].

作者信息

Kitaoka K, Abe H, Nakagawa Y, Imai T, Satoh M

出版信息

Hokkaido Igaku Zasshi. 1987 Mar;62(2):322-31.

PMID:3610029
Abstract

Eight cases with ruptured anterior communicating aneurysms, who developed mental signs of mild degree lasting more than two weeks following direct operation, were subjected to our study. The following results were obtained. The mental signs of mild degree in 8 cases consisted of memory and emotional disturbances. The main findings of CT scan was low density area in the subcortical and cortical areas of the frontal lobe. There was no close correlation on CT findings between memory and emotional disturbances. Abnormal density areas were detected on CT scan, but EEG showed no localized abnormalities of slow waves. Abnormal density areas were not clearly shown on CT, but EEG showed localized abnormalities. Background activities on EEG were favorable despite lesions detected on CT. Either local or diffuse abnormalities were observed in EEG background activities while no abnormal mental signs were recognized. In cases with no apparent abnormal findings on CT and with favorable background activities on EEG, EEG showed marked build up during hyperventilation. As indicated by the above data, comparative studies of CT and EEG findings revealed differences in sites of abnormalities and degree of abnormalities. This is considered caused by a possible increase in cerebral blood flow and metabolism at initiation of chronic stage following subarachnoid hemorrhage-resulting in the disappearance of abnormalities on EEG.

摘要

对8例前交通动脉瘤破裂患者进行了研究,这些患者在直接手术后出现轻度精神症状且持续超过两周。得到了以下结果。8例患者的轻度精神症状包括记忆和情绪障碍。CT扫描的主要发现是额叶皮质下和皮质区域的低密度区。记忆和情绪障碍在CT表现上没有密切相关性。CT扫描检测到密度异常区域,但脑电图未显示慢波的局部异常。CT上密度异常区域未清晰显示,但脑电图显示局部异常。尽管CT检测到病变,但脑电图的背景活动良好。脑电图背景活动出现局部或弥漫性异常,而未发现明显的精神症状。在CT无明显异常发现且脑电图背景活动良好的病例中,脑电图在过度换气时显示明显增强。根据上述数据,CT和脑电图结果的对比研究揭示了异常部位和异常程度的差异。这被认为是由于蛛网膜下腔出血后慢性期开始时脑血流量和代谢可能增加,导致脑电图上的异常消失。

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