Cervoni L, Salvati M, Santoro A
Istituto Mediterraneo Neurologico Neuromed, IRCCS, Pozzilli (Is), Italy.
Ital J Neurol Sci. 1996 Aug;17(4):291-4. doi: 10.1007/BF01997789.
Cerebral vasospasm is a clinical/angiographical condition frequently observed after a subarachnoid hemorrhage due to the rupture of an intracranial aneurysm. Twenty cases of vasospasm observed after the removal of cerebral tumors have been reported in the literature; we here report on a further five. The time of onset of symptomatic vasospasm was 3-7 days after surgery; three of the patients died of an ischemic event induced by the vasospasm and two survive. Although no angiographic confirmation was obtained in our cases, serial transcranial Doppler (TCD) flow velocities were always high. It is suggested that the TCD-revealed accumulation of blood in the basal cisterns observed in all cases may have been responsible for this unusual condition, and it is therefore important to consider vasospasm as a probable etiological cause of clinical deterioration in patients undergoing the surgical removal of a cerebral tumor. For this reason, whenever any neurological deterioration occurs in such patients, it is advisable to perform TCD in order to verify the presence of any vasospasm and promptly commence suitable treatment.
脑血管痉挛是一种临床/血管造影表现，常见于颅内动脉瘤破裂导致蛛网膜下腔出血后。文献报道了20例脑肿瘤切除术后发生血管痉挛的病例；我们在此再报告5例。症状性血管痉挛的发病时间为术后3 - 7天；3例患者死于血管痉挛诱发的缺血事件，2例存活。虽然我们的病例未获得血管造影证实，但经颅多普勒（TCD）血流速度一直很高。提示在所有病例中TCD显示的基底池血液积聚可能是导致这种异常情况的原因，因此在接受脑肿瘤手术切除的患者中，将血管痉挛视为临床病情恶化的可能病因很重要。因此，每当此类患者出现任何神经功能恶化时，建议进行TCD以核实是否存在血管痉挛，并立即开始适当治疗。
