Fukuhara T, Douville C M, Eliott J P, Newell D W, Winn H R
Department of Neurological Surgery, University of Washington Harborview Medical Center, Seattle, USA.
Neurol Med Chir (Tokyo). 1998 Nov;38(11):710-5; discussion 716-7. doi: 10.2176/nmc.38.710.
The relationship between intracranial pressure (ICP) and the development of vasospasm after subarachnoid hemorrhage caused by the rupture of an intracranial aneurysm was investigated. Eleven patients were divided into high (6 cases) and low (5 cases) ICP groups based on ICP data obtained during the perioperative period by continuous ICP monitoring. Transcranial Doppler ultrasonography was performed every 24 hours for 7 days and the severity, distribution, and duration of vasospasm were assessed. The high ICP group tended to have severe, prolonged, and diffuse vasospasm compared with the low ICP group. However, only duration of vasospasm was statistically different. The relationship between cerebral perfusion pressure (CPP) and the development of vasospasm was also examined. CPP had a less significant effect than ICP although similar tendencies for high ICP and low CPP were observed. High ICP worsens vasospasm and treatment for decreasing ICP with perioperative ICP monitoring has potential for avoiding the development of vasospasm.
研究了颅内动脉瘤破裂引起蛛网膜下腔出血后颅内压（ICP）与血管痉挛发生之间的关系。根据围手术期通过连续ICP监测获得的ICP数据，将11例患者分为高ICP组（6例）和低ICP组（5例）。连续7天每24小时进行一次经颅多普勒超声检查，评估血管痉挛的严重程度、分布和持续时间。与低ICP组相比，高ICP组往往出现严重、持续时间长且弥漫性的血管痉挛。然而，只有血管痉挛的持续时间存在统计学差异。还研究了脑灌注压（CPP）与血管痉挛发生之间的关系。尽管观察到高ICP和低CPP有相似趋势，但CPP的影响比ICP小。高ICP会加重血管痉挛，围手术期通过ICP监测降低ICP的治疗方法有可能避免血管痉挛的发生。
