THE CRITICAL 1ST MINUTES AFTER SUBARACHNOID HEMORRHAGE
THE CRITICAL 1ST MINUTES AFTER SUBARACHNOID HEMORRHAGE
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DOI：
10.1227/00006123-198804000-00006
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发表时间：
1988-04-01
期刊：
影响因子：
4.8
通讯作者：
HASSLER, W
中科院分区：
文献类型：
--
作者：
GROTE, E;HASSLER, W
6例患者在复发性蛛网膜下腔出血（SAH）期间进行了观察。3例患者均具有开放的颅骨和完整的硬脑膜，并显示颅内压（ICP）在1分钟内极度升高，然后在几分钟内下降。另外3例患者在再出血前、再出血时和再出血后进行了经颅多普勒超声检查，并对其血流动力学进行了研究。有确凿的证据表明，急性自发性SAH通常伴随持续数分钟的颅内循环骤停，并由平均动脉水平范围内的ICP峰值引起。讨论了相关机制。有强烈的迹象表明，这种暂时的颅内循环停止促进止血，但可能构成严重的缺血事件。
Six patients were observed during recurrent subarachnoid hemorrhage (SAH). Three each had an open skull and intact dura mater and demonstrated an extreme increase in intracranial pressure (ICP) that developed within 1 minute and then declined over several minutes. Three other patients were investigated with transcranial Doppler sonography before, during, and after recurrent bleeding, and their hemodynamics were studied. There is conclusive evidence that acute spontaneous SAH is often followed by an intracranial circulatory arrest lasting for several minutes and caused by a peak of ICP in the range of mean arterial levels. The mechanisms involved are discussed. There are strong indications that this temporary intracranial circulatory arrest promotes hemostasis, but may constitute a severe ischemic event.