Najjar F, Guttmacher L B
Department of Psychiatry, University of Rochester School of Medicine and Dentistry, New York, USA.
J ECT. 1998 Dec;14(4):266-71.
Two patients with known intracranial aneurysms (ICA) received electroconvulsive therapy (ECT). The first patient received ECT 4 years after the clipping of a right middle cerebral artery aneurysm. Treatment with esmolol failed to completely prevent an increase in blood pressure, but she did well nonetheless. The second patient underwent clipping of a basilar artery aneurysm 11 years before ECT. At the time of ECT, angiography showed a right paraophthalmic artery aneurysm. He received esmolol before each ECT, and, like the first patient, still had significant peri-ictal increases in his blood pressure, but otherwise tolerated the procedure well. Our experience and previously published literature indicate that even with pretreatment, patients often sustain significant increases in their blood pressure. However, this has not been accompanied by any morbidity. Possible guidelines for the management of ICA in association with ECT are discussed.
两名患有颅内动脉瘤（ICA）的患者接受了电休克治疗（ECT）。第一名患者在右侧大脑中动脉动脉瘤夹闭术后4年接受了ECT治疗。艾司洛尔治疗未能完全预防血压升高，但她总体情况良好。第二名患者在接受ECT治疗前11年进行了基底动脉动脉瘤夹闭术。在进行ECT时，血管造影显示右侧眶旁动脉有动脉瘤。他在每次ECT治疗前都接受了艾司洛尔治疗，并且和第一名患者一样，在发作期血压仍有显著升高，但除此之外对该治疗耐受良好。我们的经验以及先前发表的文献表明，即使进行了预处理，患者的血压仍常常会大幅升高。然而，这并未伴随任何不良后果。本文讨论了与ECT相关的颅内动脉瘤管理的可能指导原则。
