Martin L, Mercier C, Bodin D, Santini J J
Ann Fr Anesth Reanim. 1985;4(4):367-70. doi: 10.1016/s0750-7658(85)80107-6.
A case is reported of a ruptured intracranial aneurysm of the posterior cerebral artery in a 21/2 month old infant. The clinical picture of subarachnoid haemorrhage included coma, seizures and left hemiparesis. The aneurysm was detected by two dimensional ultrasonography and CT scan. The carotid and vertebral arteriogram showed an aneurysm located on the posterior cerebral artery. Surgery was performed after neurological improvement, 25 days after admission. The operation was conducted under controlled systemic hypotension using sodium nitroprusside. The mean blood pressure was decreased from 70 mmHg to 40 mmHg during 20 min. This technique established good haemostatic conditions during removal of the aneurysm. Postoperative recovery was uneventful with full neurological recovery. The interest of sodium nitroprusside as a hypotensive agent is discussed. The difficulties of monitoring haemodynamic variables in infants are stressed.
报道了一例2个半月大婴儿大脑后动脉颅内动脉瘤破裂的病例。蛛网膜下腔出血的临床表现包括昏迷、癫痫发作和左侧偏瘫。通过二维超声和CT扫描检测到动脉瘤。颈动脉和椎动脉血管造影显示动脉瘤位于大脑后动脉。入院25天后，在神经功能改善后进行了手术。手术在使用硝普钠控制全身低血压的情况下进行。在20分钟内平均血压从70 mmHg降至40 mmHg。该技术在切除动脉瘤期间建立了良好的止血条件。术后恢复顺利，神经功能完全恢复。讨论了硝普钠作为降压药物的作用。强调了监测婴儿血流动力学变量的困难。
