Hayashi M, Marukawa S, Fujii H, Kitano T, Kobayashi H, Munemoto S, Yamamoto S
Acta Neurochir (Wien). 1978;44(1-2):81-95. doi: 10.1007/BF01401632.
Intracranial pressure (ICP) was recorded continuously in 12 pre-operative patients with angiographic evidence of diffuse cerebral arterial spasm due to a ruptured intracranial aneurysm. Recordings were made for 1 to 7 days, starting within 13 days after the haemorrhage. 1. An increased ICP was observed in the first week after subarachnoid haemorrhage (SAH) in 4 of the patients without any signs of angiographic arterial spasm. 2. This initial increase was regularly followed by a depression of ICP in between 7--12 days after SAH. In 11 out of 12 patients such a depression was concomitant with the beginning of arterial spasm. During the period of depressed ICP pattern, 6 patients showed little or no neurological deterioration, whereas 5 patients showed impaired consciousness or neurological deficits. 3. A secondary rise of ICP thereafter always followed due to ischaemic brain swelling or infarction, and was usually associated with a serious neurological deterioration. 4. Continuous ventricular drainage was performed to control the secondary increased ICP in 7 patients who survived, 4 of them with good clinical improvement and 3 with severe neurological deficits. 5. In the stage of depressed ICP, the administration of isoproterenol and steroids is recommended in order to try to alleviate the secondary rise of ICP.
对12例术前颅内动脉瘤破裂且血管造影显示弥漫性脑动脉痉挛的患者进行了颅内压（ICP）连续监测。监测持续1至7天，在出血后13天内开始。1. 4例无血管造影动脉痉挛迹象的患者在蛛网膜下腔出血（SAH）后的第一周观察到ICP升高。2. 这种最初的升高通常在SAH后7至12天出现ICP下降。12例患者中有11例这种下降与动脉痉挛开始同时出现。在ICP下降阶段，6例患者几乎没有或没有神经功能恶化，而5例患者出现意识障碍或神经功能缺损。3. 此后由于缺血性脑肿胀或梗死，ICP总是继发升高，且通常伴有严重的神经功能恶化。4. 对7例存活患者进行了持续脑室引流以控制继发升高的ICP，其中4例临床改善良好，3例有严重神经功能缺损。5. 在ICP下降阶段，建议使用异丙肾上腺素和类固醇以试图减轻ICP的继发升高。
