VENOUS INFARCTION FOLLOWING THE INTERHEMISPHERIC APPROACH IN PATIENTS WITH ACUTE SUBARACHNOID HEMORRHAGE
VENOUS INFARCTION FOLLOWING THE INTERHEMISPHERIC APPROACH IN PATIENTS WITH ACUTE SUBARACHNOID HEMORRHAGE
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DOI：
10.3171/jns.1991.74.5.0715
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发表时间：
1991-05-01
影响因子：
4.1
通讯作者：
SAITO, I
中科院分区：
文献类型：
--
作者：
TSUTSUMI, K;SHIOKAWA, Y;SAITO, I
本文对48例经脑间入路行前交通动脉瘤急性期蛛网膜下腔出血（SAH）手术后静脉梗死的情况进行了研究。术中切除桥静脉的23例患者中，11例（47.8%）出现额叶静脉梗死。相比之下，17例保留桥静脉的患者中只有1例（5.9%）发生脑水肿。在第11天（SAH的当天被定义为第0天）后接受手术的8例患者中，没有一例出现这种并发症，尽管其中6例患者的桥静脉被切断。急性动脉瘤手术后静脉梗死往往在SAH级别较高和/或年龄较大的患者中更频繁发生，但这些相关性并不显著。静脉牺牲与静脉梗死的相关性有统计学意义（p < 0.025）。由于这种潜在的并发症可能会损害急性动脉瘤手术的益处并造成损伤，因此保护静脉系统是很重要的，在某些情况下，根据额叶静脉引流的模式选择另一种手术方式。
Postoperative venous infarction following aneurysm surgery was studied in 48 patients with anterior communicating artery aneurysms operated on through the interhemispheric approach at the acute stage of subarachnoid hemorrhage (SAH). Of 23 patients whose bridging veins were sacrificed during surgery, 11 (47.8%) showed venous infarction in the frontal lobes. In contrast, only one (5.9%) of 17 patients whose bridging veins were preserved developed cerebral edema. None of eight patients who were operated on after Day 11 (the day of SAH was defined as Day 0) showed this complication, although bridging veins were sacrificed in six of them. Venous infarction following acute aneurysm surgery tended to occur more frequently in patients of higher SAH grade and/or more advanced age, but these correlations were not significant. However, the correlation between the sacrifice of veins and venous infarction was significant (p < 0.025). Because this potential complication may compromise the benefit of acute aneurysm surgery and cause damage, it is important to preserve the venous system and in some instances to select another surgical approach based on the pattern of venous drainage in the frontal lobe.