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脑血管痉挛后动脉闭塞(作者译)

[Arterial occlusion following cerebral vasospasm (author's transl)].

作者信息

Kim H, Mizukami M, Kawase T, Araki G

出版信息

No Shinkei Geka. 1979 Feb;7(2):159-65.

PMID:424063
Abstract
  1. The present study analysed the clinical course, the serial angiograms and the CT scans of the patients with angiographic arterial occlusion following vasospasm after subarachnoid hemorrhage. The occlusion was observed in 6 out of 84 patients with vasospasm. 2. The angiograms which showed this phenomenon were obtained between the 11th and the 30th day of the illness. The affected vessels were the branches of middle cerebral artery. 3. Thrombus formed on the intima which had been injured by vasospasm is suspected to be a genesis of this arterial occlusion. The pathological findings of a case in this series support this concept. 4. The surgical procedure during the direct aneurysmal operation performed in the period of "smooth narrowing" seems to be a contributing factor to the arterial occlusion. There was no correlation between antifibrinolytic therapy and this phenomenon except in one case. 5. Fibrinolytic therapy after clipping of aneurysm may be a treatment of choice for this arterial occlusion following vasospasm.
摘要
  1. 本研究分析了蛛网膜下腔出血后血管痉挛导致血管造影动脉闭塞患者的临床病程、系列血管造影及CT扫描结果。84例血管痉挛患者中有6例出现闭塞。2. 显示此现象的血管造影是在发病第11天至30天期间获得的。受累血管为大脑中动脉分支。3. 怀疑在因血管痉挛而受损的内膜上形成的血栓是这种动脉闭塞的成因。本系列中的一例病例的病理结果支持这一观点。4. 在“平滑狭窄”期进行直接动脉瘤手术时的手术操作似乎是导致动脉闭塞的一个因素。除1例病例外,抗纤溶治疗与该现象之间无相关性。5. 动脉瘤夹闭术后的纤溶治疗可能是这种血管痉挛后动脉闭塞的首选治疗方法。

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