脳卒中の外科
Online ISSN : 1880-4683
Print ISSN : 0914-5508
ISSN-L : 0914-5508
クモ膜下出血後のdelayed ischemic neurological deficitsに対する新しい予防法
日下 和昌行天 徹矢瀬尾 善宣松本 圭蔵
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1989 年 17 巻 4 号 p. 349-353

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Prevention of delated ischemic neurological deficits (DIND) following subarachnoid hemorrhage (SAH) has been tried by the surgical removal of subarachnoid hematoma as much as possible during the operation and continuous drainage of the cerebral ventricle and cistern postoperatively. Concomitant pharmacotherapies with administration of mannitol, glyceol, steroid, nizophenon, low-molecular dextran, barbital, Ca++ antagonists, or antithrombocyte agents as well as management of Hypervolemia and Hypertension have been used and the clinical outcome is generally improving. In spite of the above treatments, however, prognosis is still infavorable in some cases. Delayed vasospasm is thought to be caused by an angiospastic substance produced in the course of decomposition of the shed blood. We administered urinastatin and gebaxate medilate, polyvalent anti-enzymatic agents, immediately after SAH and our clinical observation has led to the impression that the treatment could prevent DIND in the patients.
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© 一般社団法人 日本脳卒中の外科学会
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