Cisternal washing therapy in the patients with subarachnoid hemorrhage of high grades
| Autor: | Akira Tamura, Teruyuki Ishii, Tadayoshi Nakagomi, Jae-Hynn Son, Masahumi Hirata, Kiyoshi Takagi, Hiroshi Nagashima |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Urokinase
medicine.medical_specialty Subarachnoid hemorrhage business.industry Cerebral infarction medicine.medical_treatment Incidence (epidemiology) Infarction Vasospasm General Medicine Clipping (medicine) medicine.disease nervous system diseases Surgery body regions Cerebral vasospasm Anesthesia cardiovascular system medicine cardiovascular diseases business circulatory and respiratory physiology medicine.drug |
| Zdroj: | International Congress Series. 1259:159-162 |
| ISSN: | 0531-5131 |
| Popis: | In this paper, we retrospectively analyzed the effect of cisternal washing therapy using urokinase combined with head shaking in preventing vasospasm in patients of high subarachnoid hemorrhage (SAH) grades. Since 1988, a total of 250 consecutive cases in Fisher group 3 were retrospectively analyzed. Of these patients, 56 were diagnosed as grade 4 or 5 according to WFNS grading. Thirty cases had cisternal washing therapy and 26 cases, not. All of these patients had clipping operations within 3 days following SAH, ventricular or cisternal drainage during the clipping operation, and postoperative management with normovolemia and normo-mild hypertension. In these two groups, the incidence of symptomatic vasospasm (transiently symptomatic vasospasm without infarction), cerebral infarction on CT, and mortality and morbidity (M&M) (below moderately disabled) due to vasospasm was analyzed. In the group without cisternal washing, the incidence of symptomatic vasospasm, cerebral infarction on CT, and M&M due to vasospasm was 0%, 30.7%, and 23.1%, respectively. On the other hand, in the group with cisternal washing, the incidence of symptomatic vasospasm, cerebral infarction on CT, and M&M due to vasospasm was 13.3%, 0%, and 3.33%, respectively. Cisternal washing therapy was, therefore, effective to prevent cerebral infarction due to vasospasm. |
| Databáze: | OpenAIRE |
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