Spinal cord stimulation for cerebral vasospasm as prophylaxis.
Spinal cord stimulation for cerebral vasospasm as prophylaxis.
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脊髓刺激可预防脑血管痉挛。
DOI：
10.2176/nmc.40.352
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发表时间：
2000
影响因子：
1.9
通讯作者：
Masamichi Shinonaga
中科院分区：
文献类型：
--
作者：
Yoshihiro Takanashi;Masamichi Shinonaga
对 10 名患有 Hunt 和 Hess 3 级或 4 级固定性脑动脉瘤以及 Fisher 3 级蛛网膜下腔出血 (SAH) 的患者采用颈髓刺激 (SCS) 来增加脑血流量 (CBF)。动脉瘤手术后，患者通过经皮导线接受先发性电刺激。所有患者还接受高容量治疗和尼卡地平。使用氙计算机断层扫描和脑血管造影评估治疗效果。 SCS 后大脑中动脉分布的 CBF 显着增加 (p < 0.05)。 10名患者中有4名出现血管造影血管痉挛，但没有一人出现严重的脑血管痉挛后遗症。 10 名患者中有 7 名的总体结果良好或优秀。没有观察到 SCS 引起的严重不良反应。液体管理和钙拮抗剂对 SAH 后的脑血管痉挛有有益作用，但对某些患者不耐受或无效。 SCS 作为 SAH 后脑血管痉挛的辅助治疗可能对预后产生有利的影响。
Cervical spinal cord stimulation (SCS) was used to increase cerebral blood flow (CBF) in 10 patients with secured cerebral aneurysms in Hunt and Hess grade 3 or 4 and with Fisher group 3 subarachnoid hemorrhage (SAH). The patients underwent preemptive electrical stimulation through a percutaneous lead following aneurysm surgery. All patients also received hypervolemic therapy and nicardipine. Efficacy of the treatment was evaluated using xenon computed tomography and cerebral angiography. The CBF in the distribution of the middle cerebral artery significantly increased following SCS (p < 0.05). Four of 10 patients showed angiographic vasospasm, but none developed severe sequelae of cerebral vasospasm. The overall outcome was good or excellent in seven of the 10 patients. No serious adverse effects due to SCS were observed. Fluid management and calcium antagonist have a beneficial effect on cerebral vasospasm following SAH, but is not tolerated or is ineffective in some patients. SCS as an adjunctive therapy for cerebral vasospasm following SAH may have a favorable effect on outcome.