高血圧性被殻出血の治療方針と予後 重症例に対するＣＴ誘導下定位脳手術の治療成績
書誌事項
- タイトル別名
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- Clinical results of CT-guided stereotaxic surgery for patients with high-grade hypertensive putaminal hemorrhage.
- 重症例に対するCT誘導下定位脳手術の治療成績
抄録
In order to elucidate the usufulness and safety of CT-guided stereotactic surgery for the treatment of Pa-tients with high-grade putaminal hemorrhage, we retrospectively compared the outcome of patients treated by stereotaxic surgery or craniotomy under general anesthesia. For the past eight years, 33 patients with high-grade putaminal hemorrhage were treated by craniotomy and 27 patients were treated by stereotaxic surgery. For stereotaxic surgery we used Komai CT stereotactic apparatus and inserted two drainage tubes to different target points through one burr hole under strict control of blood pressure. The tube placed in the center of the hematoma cavity was used to inject a solution of 6, 000 IU urokinase in 2 ml saline and the other tube placed in the posterior site of the cavity was for persistent drainage of the hematoma clot expecting syphone effect.<BR>Overall satisfactory outcome was obtained in 18 of 33 patients (54%) in craniotomy group and in 17 of 27 patients (63%) in stereotaxic group. In craniotomy group, 8 of 15 patients (53%) with poor outcome deterio-rated due to pulmonaly complication. In stereotaxic group, postoperative CT scan demonstrated sufficient re-duction of hematoma volume without rebleeding in all patients except for three patients with chronic renal failure.<BR>As a conclusion, stereotaxic surgery under the close control of bood pressure was safe and usuful method for the treatment of patients with high-grade putaminal hemorrhage as far as the patients do not have chronic renal failure.
収録刊行物
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- 脳卒中
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脳卒中 22 (4), 595-599, 2000
一般社団法人 日本脳卒中学会
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詳細情報 詳細情報について
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- CRID
- 1390001204639525632
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- NII論文ID
- 130003439114
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- ISSN
- 18831923
- 09120726
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- 本文言語コード
- ja
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- データソース種別
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- JaLC
- Crossref
- CiNii Articles
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- 抄録ライセンスフラグ
- 使用不可