Suzuki S, Ogane K, Souma M, Ohkuma H, Iwabuchi T
Department of Neurosurgery, Hirosaki University School of Medicine, Japan.
Acta Neurochir (Wien). 1994;131(3-4):184-8. doi: 10.1007/BF01808610.
A series of 55 patients with ruptured cerebral aneurysms were treated with moderate removal of subarachnoid clot followed by intracranial irrigation with pH 8.0 Hartmann solution containing 1 mg/ml of methylpredonisolone sodium succinate after the aneurysmal clipping during early (before day 3) operation. Six (11%) of the 55 patients suffered vasospasm syndrome postoperatively. The clinical results are significantly better than a series of 68 patients operated on and treated before day 3 by intracranial irrigation with Hartmann solution (pH 8.0) only. The possible preventive effect of direct intracranial administration of steroid hormone is discussed.
55例脑动脉瘤破裂患者在早期(第3天之前)手术中进行动脉瘤夹闭后,适度清除蛛网膜下腔血凝块,随后用含1mg/ml琥珀酸钠甲泼尼龙的pH 8.0哈特曼溶液进行颅内冲洗。55例患者中有6例(11%)术后出现血管痉挛综合征。临床结果明显优于仅用pH 8.0哈特曼溶液进行颅内冲洗且在第3天之前手术治疗的68例患者。文中讨论了直接颅内给予类固醇激素可能的预防作用。