Song J K, Elliott J P, Eskridge J M
Department of Radiology, University of Washington, Seattle, Washington 98195, USA.
Neuroimaging Clin N Am. 1997 Nov;7(4):819-35.
For survivors of aneurysmal subarachnoid hemorrhage, cerebral vasospasm significantly contributes to its morbidity and mortality by causing delayed ischemic neurological deficit. Noninvasive evaluation with computed tomography, transcranial doppler and single photon emission computerized tomography helps guide clinical decisions. Endovascular therapy of symptomatic vasospasm with balloon angioplasty and to a lesser extent with intraarterial papaverine infusion has emerged as an important treatment adjunct to neurosurgical medical and operative management. Early and aggressive treatment with balloon angioplasty has resulted in sustained clinical improvement in about two-thirds of patients suffering from neurological deficits attributable to vasospasm. Encouraging long-term clinical and transcranial artery damage following angioplasty. Despite balloon angioplasty's 2% to 5% peri-procedure mortality rate, it remains under used.
对于动脉瘤性蛛网膜下腔出血的幸存者，脑血管痉挛通过导致延迟性缺血性神经功能缺损，显著增加了其发病率和死亡率。计算机断层扫描、经颅多普勒和单光子发射计算机断层扫描等无创评估有助于指导临床决策。症状性血管痉挛的血管内治疗，如球囊血管成形术以及在较小程度上的动脉内罂粟碱输注，已成为神经外科药物和手术治疗的重要辅助手段。早期积极进行球囊血管成形术治疗，已使约三分之二因血管痉挛导致神经功能缺损的患者获得持续的临床改善。血管成形术后的长期临床和经颅动脉损伤令人鼓舞。尽管球囊血管成形术的围手术期死亡率为2%至5%，但其应用仍然不足。
