重症くも膜下出血に対する治療

重症くも膜下出血 (SAH) 患者の転帰は依然, 不良である. 良好な転帰を得る可能性を高めるためには, 新たな脳損傷を加えることなく早期に脳動脈瘤に対する根治術を施行する必要があるが, 同時にさまざまな全身性合併症の治療, 早期脳損傷を伴う頭蓋内圧亢進に対する迅速な管理, 遅発性脳虚血対策などの集中治療が必要である. 転帰不良の主な原因は早期脳損傷や続発する遅発性脳虚血であるが, 重症SAHでより問題となる脳血管攣縮を伴わない遅発性脳虚血に対する治療法やモニタリング法は確立されていない. 微小循環障害やその原因病態を標的とした早期脳損傷や遅発性脳虚血に対する新たな治療法の開発が待たれる....

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Published in脳神経外科ジャーナル Vol. 29; no. 2; pp. 109 - 115
Main Authors 浅田, 玲緒尚, 金丸, 英樹, 川北, 文博, 当麻, 直樹, 芝, 真人, 鈴木, 秀謙, 三浦, 洋一, 藤本, 昌志
Format Journal Article
LanguageJapanese
Published 日本脳神経外科コングレス 2020
Subjects
delayed cerebral ischemia
early brain injury
epilepsy
subarachnoid hemorrhage
systemic complication
Online AccessGet full text
ISSN0917-950X
2187-3100
DOI10.7887/jcns.29.109

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Abstract 重症くも膜下出血 (SAH) 患者の転帰は依然, 不良である. 良好な転帰を得る可能性を高めるためには, 新たな脳損傷を加えることなく早期に脳動脈瘤に対する根治術を施行する必要があるが, 同時にさまざまな全身性合併症の治療, 早期脳損傷を伴う頭蓋内圧亢進に対する迅速な管理, 遅発性脳虚血対策などの集中治療が必要である. 転帰不良の主な原因は早期脳損傷や続発する遅発性脳虚血であるが, 重症SAHでより問題となる脳血管攣縮を伴わない遅発性脳虚血に対する治療法やモニタリング法は確立されていない. 微小循環障害やその原因病態を標的とした早期脳損傷や遅発性脳虚血に対する新たな治療法の開発が待たれる.
AbstractList 重症くも膜下出血 (SAH) 患者の転帰は依然, 不良である. 良好な転帰を得る可能性を高めるためには, 新たな脳損傷を加えることなく早期に脳動脈瘤に対する根治術を施行する必要があるが, 同時にさまざまな全身性合併症の治療, 早期脳損傷を伴う頭蓋内圧亢進に対する迅速な管理, 遅発性脳虚血対策などの集中治療が必要である. 転帰不良の主な原因は早期脳損傷や続発する遅発性脳虚血であるが, 重症SAHでより問題となる脳血管攣縮を伴わない遅発性脳虚血に対する治療法やモニタリング法は確立されていない. 微小循環障害やその原因病態を標的とした早期脳損傷や遅発性脳虚血に対する新たな治療法の開発が待たれる.
Author 鈴木, 秀謙
当麻, 直樹
川北, 文博
浅田, 玲緒尚
金丸, 英樹
藤本, 昌志
三浦, 洋一
芝, 真人
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  fullname: 三浦, 洋一
  organization: 三重大学大学院医学系研究科脳神経外科
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  fullname: 藤本, 昌志
  organization: 三重大学大学院医学系研究科脳神経外科
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References 8) De Marchis GM, Pugin D, Lantigua H, Zammit C, Tadi P, Schmidt JM, Falo MC, Agarwal S, Mayer SA, Claassen J : Tonic-clonic activity at subarachnoid hemorrhage onset : impact on complications and outcome. PLoS One 8 : e71405, 2013.
30) Woitzik J, Dreier JP, Hecht N, Fiss I, Sandow N, Major S, Winkler M, Dahlem YA, Manville J, Diepers M, Muench E, Kasuya H, Schmiedek P, Vajkoczy P ; COSBID study group : Delayed cerebral ischemia and spreading depolarization in absence of angiographic vasospasm after subarachnoid hemorrhage. J Cereb Blood Flow Metab 32 : 203-212, 2012.
14) Han Y, Ye F, Long X, Li A, Xu H, Zou L, Yang Y, You C : Ultra-early treatment for poor-grade aneurysmal subarachnoid hemorrhage : a systematic review and meta-analysis. World Neurosurg 115 : e160-e171, 2018.
32) Yoneda H, Nakamura T, Shirao S, Tanaka N, Ishihara H, Suehiro E, Koizumi H, Isotani E, Suzuki M ; SAH PiCCO Study Group : Multicenter prospective cohort study on volume management after subarachnoid hemorrhage : hemodynamic changes according to severity of subarachnoid hemorrhage and cerebral vasospasm. Stroke 44 : 2155-2161, 2013.
12) Frontera JA, Claassen J, Schmidt JM, Wartenberg KE, Temes R, Connolly ES Jr, MacDonald RL, Mayer SA : Prediction of symptomatic vasospasm after subarachnoid hemorrhage : the modified fisher scale. Neurosurgery 59 : 21-27, 2006.
3) Badiatia N, Fernandez L, Schlossberg MJ, Schmidt JM, Claassen J, Lee K, Connolly ES, Mayer SA, Rosenbaum M : Relationship between energy balance and complications after subarachnoid hemorrhage. JPEN J Parenter Enteral Nutr 34 : 64-69, 2010.
22) Molyneux A, Kerr R, Stratton I, Sandercock P, Clarke M, Shrimpton J, Holman R ; International Subarachnoid Aneurysm Trial (ISAT) Collaborative Group : International Subarachnoid Aneurysm Trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms : a randomised trial. Lancet 360 : 1267-1274, 2002.
18) Kasuya H, Kawashima A, Namiki K, Shimizu T, Takakura K : Metabolic profiles of patients with subarachnoid hemorrhage treated by early surgery. Neurosurgery 42 : 1268-1274, 1998.
21) Marigold R, Günther A, Tiwari D, Kwan J : Antiepileptic drugs for the primary and secondary prevention of seizures after subarachnoid haemorrhage. Cochrane Database Syst Rev 6 : Cd008710, 2013.
2) Alotaibi NM, Elkarim GA, Samuel N, Ayling OGS, Guha D, Fallah A, Aldakkan A, Jaja BNR, de Oliveira Manoel AL, Ibrahim GM, Macdonald RL : Effects of decompressive craniectomy on functional outcomes and death in poor-grade aneurysmal subarachnoid hemorrhage : a systematic review and meta-analysis. J Neurosurg 127 : 1315-1325, 2017.
15) Hänggi D, Etminan N, Aldrich F, Steiger HJ, Mayer SA, Diringer MN, Hoh BL, Mocco J, Faleck HJ, Macdonald RL, NEWTON Investigators : Randomized, open-label, phase 1/2a study to determine the maximum tolerated dose of intraventricular sustained release nimodipine for subarachnoid hemorrhage. Stroke 48 : 145-151, 2017.
10) Diringer MN, Bleck TP, Claude Hemphill J 3rd, Menon D, Shutter L, Vespa P, Bruder N, Connolly ES Jr, Citerio G, Gress D, Hänggi D, Hoh BL, Lanzino G, Le Roux P, Rabinstein A, Schmutzhard E, Stocchetti N, Suarez JI, Treggiari M, Tseng MY, Vergouwen MD, Wolf S, Zipfel G ; Neurocritical Care Society : Critical care management of patients following aneurysmal subarachnoid hemorrhage : recommendations from the Neurocritical Care Society's Multidisciplinary Consensus Conference. Neurocrit Care 15 : 211-240, 2011.
11) Eickhoff M, Kovac S, Shahabi P, Ghadiri MK, Dreier JP, Stummer W, Speckmann EJ, Pape HC, Gorji A : Spreading depression triggers ictaform activity in partially disinhibited neuronal tissues. Exp Neurol 253 : 1-15, 2014.
13) Gessler F, Mutlak H, Lamb S, Hartwich M, Adelmann M, Platz J, Konczalla J, Seifert V, Senft C : The impact of tracheostomy timing on clinical outcome and adverse events in poor-grade subarachnoid hemorrhage. Crit Care Med 43 : 2429-2438, 2015.
23) Petruk KC, West M, Mohr G, Weir BK, Benoit BG, Gentili F, Disney LB, Khan MI, Grace M, Holness RO, Karwon MS, Ford RM, Cameron GS, Tucker WS, Purves GB, Miller JDR, Hunter KM, Richard MT, Durity FA, Chan R, Clein LJ, Maroun FB, Godon A : Nimodipine treatment in poor-grade aneurysm patients : results of a multicenter double-blind placebo-controlled trial. J Neurosurg 68 : 505-517, 1988.
5) Butzkueven H, Evans AH, Pitman A, Leopold C, Jolley DJ, Kaye AH, Kilpatrick CJ, Davis SM : Onset seizures independently predict poor outcome after subarachnoid hemorrhage. Neurology 55 : 1315-1320, 2000.
19) Kim JA, Rosenthal ES, Biswal S, Zafar S, Shenoy AV, O'Connor KL, Bechek SC, Valdery Moura J, Shafi MM, Patel AB, Cash SS, Westover MB : Epileptiform abnormalities predict delayed cerebral ischemia in subarachnoid hemorrhage. Clin Neurophysiol 128 : 1091-1099, 2017.
29) Suzuki H, Nakatsuka Y, Yasuda R, Shiba M, Miura Y, Terashima M, Suzuki Y, Hakozaki K, Goto F, Toma N : Dose-dependent inhibitory effects of cilostazol on delayed cerebral infarction after aneurysmal subarachnoid hemorrhage. Transl Stroke Res 10 : 381-388, 2019.
24) Sasahara A, Suzuki K, Takahashi Y, Koseki H, Hirota K, Ohbuchi H, Kasuya H : Prognostic assessment of aneurysmal subarachnoid patients with WFNS grade Ⅴ by CT perfusion on arrival. World Neurosurg 92 : 1-6, 2016.
4) Boulouis G, Labeyrie MA, Raymond J, Rodriguez-Régent C, Lukaszewicz AC, Bresson D, Ben Hassen W, Trystram D, Meder JF, Oppenheim C, Naggara O : Treatment of cerebral vasospasm following aneurysmal subarachnoid haemorrhage : a systematic review and meta-analysis. Eur Radiol 27 : 3333-3342, 2017.
9) de Oliveira Manoel AL, Goffi A, Marotta TR, Schweizer TA, Abrahamson S, Macdonald RL : The critical care management of poor-grade subarachnoid haemorrhage. Crit Care 20 : 21, 2016.
16) Hoogmoed J, Coert BA, van den Berg R, Roos YBWEM, Horn J, Vandertop WP, Verbaan D : Early treatment decisions in poor-grade patients with subarachnoid hemorrhage. World Neurosurg 119 : e568-e573, 2018.
28) 鈴木秀謙, 西川拓文, 中塚慶徳, 中野芙美, 岡田 健, 芝 真人 : スパズムの概念および治療の変遷と現状の課題. 脳外誌 27 : 216-221, 2018.
27) 鈴木秀謙, 川北文博 : 脳血管攣縮の病態 : 最新の知見. 豊田一則, 高橋 淳編 : 脳出血・くも膜下出血診療読本. 東京, 中外医学社, 2016, pp.355-367.
7) Claassen J, Albers D, Schmidt JM, De Marchis GM, Pugin D, Falo CM, Mayer SA, Cremers S, Agarwal S, Elkind MS, Connolly ES, Dukic V, Hripcsak G, Badjatia N : Nonconvulsive seizures in subarachnoid hemorrhage link inflammation and outcome. Ann Neurol 75 : 771-781, 2014.
6) Choi W, Kwon SC, Lee WJ, Weon YC, Choi B, Lee H, Park ES, Ahn R : Feasibility and safety of mild therapeutic hypothermia in poor-grade subarachnoid hemorrhage : prospective pilot study. J Korean Med Sci 32 : 1337-1344, 2017.
31) Xia ZW, Liu XM, Wang JY, Cao H, Chen FH, Huang J, Li QZ, Fan SS, Jiang B, Chen ZG, Cheng Q : Coiling is not superior to clipping in patients with high-grade aneurysmal subarachnoid hemorrhage : systematic review and meta-analysis. World Neurosurg 98 : 411-420, 2017.
20) Konczalla J, Seifert V, Beck J, Güresir E, Vatter H, Raabe A, Marquardt G : Outcome after Hunt and Hess Grade Ⅴ subarachnoid hemorrhage : a comparison of pre-coiling era (1980-1995) versus post-ISAT era (2005-2014). J Neurosurg 128 : 100-110, 2018.
17) Hwang US, Shin HS, Lee SH, Koh JS : Decompressive surgery in patients with poor-grade aneurysmal subarachnoid hemorrhage : clipping with simultaneous decompression versus coil embolization followed by decompression. J Cerebrovasc Endovasc Neurosurg 16 : 254-261, 2014.
25) Sato K, Shimizu H, Fujimura M, Inoue T, Matsumoto Y, Tominaga T : Acute-stage diffusion-weighted magnetic resonance imaging for predicting outcome of poor-grade aneurysmal subarachnoid hemorrhage. J Cereb Blood Flow Metab 30 : 1110-1120, 2010.
1) Ahn SH, Savarraj JP, Pervez M, Jones W, Park J, Jeon SB, Kwon SU, Chang TR, Lee K, Kim DH, Day AL, Choi HA : The subarachnoid hemorrhage early brain edema score predicts delayed cerebral ischemia and clinical outcomes. Neurosurgery 83 : 137-145, 2018.
26) 鈴木秀謙, 川北文博, 刘 磊, 市川尚己, 藤本昌志, 芝 真人 : くも膜下出血後の遅発性虚血性脳障害をめぐる新展開. 脳外誌 24 : 232-238, 2015.
33) Zarbock SD, Steinke D, Hatton J, Magnuson B, Smith KM, Cook AM : Successful enteral nutritional support in the neurocritical care unit. Neurocrit Care 9 : 210-216, 2008.
References_xml – reference: 1) Ahn SH, Savarraj JP, Pervez M, Jones W, Park J, Jeon SB, Kwon SU, Chang TR, Lee K, Kim DH, Day AL, Choi HA : The subarachnoid hemorrhage early brain edema score predicts delayed cerebral ischemia and clinical outcomes. Neurosurgery 83 : 137-145, 2018.
– reference: 20) Konczalla J, Seifert V, Beck J, Güresir E, Vatter H, Raabe A, Marquardt G : Outcome after Hunt and Hess Grade Ⅴ subarachnoid hemorrhage : a comparison of pre-coiling era (1980-1995) versus post-ISAT era (2005-2014). J Neurosurg 128 : 100-110, 2018.
– reference: 4) Boulouis G, Labeyrie MA, Raymond J, Rodriguez-Régent C, Lukaszewicz AC, Bresson D, Ben Hassen W, Trystram D, Meder JF, Oppenheim C, Naggara O : Treatment of cerebral vasospasm following aneurysmal subarachnoid haemorrhage : a systematic review and meta-analysis. Eur Radiol 27 : 3333-3342, 2017.
– reference: 15) Hänggi D, Etminan N, Aldrich F, Steiger HJ, Mayer SA, Diringer MN, Hoh BL, Mocco J, Faleck HJ, Macdonald RL, NEWTON Investigators : Randomized, open-label, phase 1/2a study to determine the maximum tolerated dose of intraventricular sustained release nimodipine for subarachnoid hemorrhage. Stroke 48 : 145-151, 2017.
– reference: 29) Suzuki H, Nakatsuka Y, Yasuda R, Shiba M, Miura Y, Terashima M, Suzuki Y, Hakozaki K, Goto F, Toma N : Dose-dependent inhibitory effects of cilostazol on delayed cerebral infarction after aneurysmal subarachnoid hemorrhage. Transl Stroke Res 10 : 381-388, 2019.
– reference: 16) Hoogmoed J, Coert BA, van den Berg R, Roos YBWEM, Horn J, Vandertop WP, Verbaan D : Early treatment decisions in poor-grade patients with subarachnoid hemorrhage. World Neurosurg 119 : e568-e573, 2018.
– reference: 24) Sasahara A, Suzuki K, Takahashi Y, Koseki H, Hirota K, Ohbuchi H, Kasuya H : Prognostic assessment of aneurysmal subarachnoid patients with WFNS grade Ⅴ by CT perfusion on arrival. World Neurosurg 92 : 1-6, 2016.
– reference: 3) Badiatia N, Fernandez L, Schlossberg MJ, Schmidt JM, Claassen J, Lee K, Connolly ES, Mayer SA, Rosenbaum M : Relationship between energy balance and complications after subarachnoid hemorrhage. JPEN J Parenter Enteral Nutr 34 : 64-69, 2010.
– reference: 10) Diringer MN, Bleck TP, Claude Hemphill J 3rd, Menon D, Shutter L, Vespa P, Bruder N, Connolly ES Jr, Citerio G, Gress D, Hänggi D, Hoh BL, Lanzino G, Le Roux P, Rabinstein A, Schmutzhard E, Stocchetti N, Suarez JI, Treggiari M, Tseng MY, Vergouwen MD, Wolf S, Zipfel G ; Neurocritical Care Society : Critical care management of patients following aneurysmal subarachnoid hemorrhage : recommendations from the Neurocritical Care Society's Multidisciplinary Consensus Conference. Neurocrit Care 15 : 211-240, 2011.
– reference: 8) De Marchis GM, Pugin D, Lantigua H, Zammit C, Tadi P, Schmidt JM, Falo MC, Agarwal S, Mayer SA, Claassen J : Tonic-clonic activity at subarachnoid hemorrhage onset : impact on complications and outcome. PLoS One 8 : e71405, 2013.
– reference: 30) Woitzik J, Dreier JP, Hecht N, Fiss I, Sandow N, Major S, Winkler M, Dahlem YA, Manville J, Diepers M, Muench E, Kasuya H, Schmiedek P, Vajkoczy P ; COSBID study group : Delayed cerebral ischemia and spreading depolarization in absence of angiographic vasospasm after subarachnoid hemorrhage. J Cereb Blood Flow Metab 32 : 203-212, 2012.
– reference: 14) Han Y, Ye F, Long X, Li A, Xu H, Zou L, Yang Y, You C : Ultra-early treatment for poor-grade aneurysmal subarachnoid hemorrhage : a systematic review and meta-analysis. World Neurosurg 115 : e160-e171, 2018.
– reference: 2) Alotaibi NM, Elkarim GA, Samuel N, Ayling OGS, Guha D, Fallah A, Aldakkan A, Jaja BNR, de Oliveira Manoel AL, Ibrahim GM, Macdonald RL : Effects of decompressive craniectomy on functional outcomes and death in poor-grade aneurysmal subarachnoid hemorrhage : a systematic review and meta-analysis. J Neurosurg 127 : 1315-1325, 2017.
– reference: 19) Kim JA, Rosenthal ES, Biswal S, Zafar S, Shenoy AV, O'Connor KL, Bechek SC, Valdery Moura J, Shafi MM, Patel AB, Cash SS, Westover MB : Epileptiform abnormalities predict delayed cerebral ischemia in subarachnoid hemorrhage. Clin Neurophysiol 128 : 1091-1099, 2017.
– reference: 7) Claassen J, Albers D, Schmidt JM, De Marchis GM, Pugin D, Falo CM, Mayer SA, Cremers S, Agarwal S, Elkind MS, Connolly ES, Dukic V, Hripcsak G, Badjatia N : Nonconvulsive seizures in subarachnoid hemorrhage link inflammation and outcome. Ann Neurol 75 : 771-781, 2014.
– reference: 5) Butzkueven H, Evans AH, Pitman A, Leopold C, Jolley DJ, Kaye AH, Kilpatrick CJ, Davis SM : Onset seizures independently predict poor outcome after subarachnoid hemorrhage. Neurology 55 : 1315-1320, 2000.
– reference: 18) Kasuya H, Kawashima A, Namiki K, Shimizu T, Takakura K : Metabolic profiles of patients with subarachnoid hemorrhage treated by early surgery. Neurosurgery 42 : 1268-1274, 1998.
– reference: 9) de Oliveira Manoel AL, Goffi A, Marotta TR, Schweizer TA, Abrahamson S, Macdonald RL : The critical care management of poor-grade subarachnoid haemorrhage. Crit Care 20 : 21, 2016.
– reference: 12) Frontera JA, Claassen J, Schmidt JM, Wartenberg KE, Temes R, Connolly ES Jr, MacDonald RL, Mayer SA : Prediction of symptomatic vasospasm after subarachnoid hemorrhage : the modified fisher scale. Neurosurgery 59 : 21-27, 2006.
– reference: 22) Molyneux A, Kerr R, Stratton I, Sandercock P, Clarke M, Shrimpton J, Holman R ; International Subarachnoid Aneurysm Trial (ISAT) Collaborative Group : International Subarachnoid Aneurysm Trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms : a randomised trial. Lancet 360 : 1267-1274, 2002.
– reference: 27) 鈴木秀謙, 川北文博 : 脳血管攣縮の病態 : 最新の知見. 豊田一則, 高橋 淳編 : 脳出血・くも膜下出血診療読本. 東京, 中外医学社, 2016, pp.355-367.
– reference: 6) Choi W, Kwon SC, Lee WJ, Weon YC, Choi B, Lee H, Park ES, Ahn R : Feasibility and safety of mild therapeutic hypothermia in poor-grade subarachnoid hemorrhage : prospective pilot study. J Korean Med Sci 32 : 1337-1344, 2017.
– reference: 28) 鈴木秀謙, 西川拓文, 中塚慶徳, 中野芙美, 岡田 健, 芝 真人 : スパズムの概念および治療の変遷と現状の課題. 脳外誌 27 : 216-221, 2018.
– reference: 32) Yoneda H, Nakamura T, Shirao S, Tanaka N, Ishihara H, Suehiro E, Koizumi H, Isotani E, Suzuki M ; SAH PiCCO Study Group : Multicenter prospective cohort study on volume management after subarachnoid hemorrhage : hemodynamic changes according to severity of subarachnoid hemorrhage and cerebral vasospasm. Stroke 44 : 2155-2161, 2013.
– reference: 11) Eickhoff M, Kovac S, Shahabi P, Ghadiri MK, Dreier JP, Stummer W, Speckmann EJ, Pape HC, Gorji A : Spreading depression triggers ictaform activity in partially disinhibited neuronal tissues. Exp Neurol 253 : 1-15, 2014.
– reference: 25) Sato K, Shimizu H, Fujimura M, Inoue T, Matsumoto Y, Tominaga T : Acute-stage diffusion-weighted magnetic resonance imaging for predicting outcome of poor-grade aneurysmal subarachnoid hemorrhage. J Cereb Blood Flow Metab 30 : 1110-1120, 2010.
– reference: 13) Gessler F, Mutlak H, Lamb S, Hartwich M, Adelmann M, Platz J, Konczalla J, Seifert V, Senft C : The impact of tracheostomy timing on clinical outcome and adverse events in poor-grade subarachnoid hemorrhage. Crit Care Med 43 : 2429-2438, 2015.
– reference: 31) Xia ZW, Liu XM, Wang JY, Cao H, Chen FH, Huang J, Li QZ, Fan SS, Jiang B, Chen ZG, Cheng Q : Coiling is not superior to clipping in patients with high-grade aneurysmal subarachnoid hemorrhage : systematic review and meta-analysis. World Neurosurg 98 : 411-420, 2017.
– reference: 26) 鈴木秀謙, 川北文博, 刘 磊, 市川尚己, 藤本昌志, 芝 真人 : くも膜下出血後の遅発性虚血性脳障害をめぐる新展開. 脳外誌 24 : 232-238, 2015.
– reference: 17) Hwang US, Shin HS, Lee SH, Koh JS : Decompressive surgery in patients with poor-grade aneurysmal subarachnoid hemorrhage : clipping with simultaneous decompression versus coil embolization followed by decompression. J Cerebrovasc Endovasc Neurosurg 16 : 254-261, 2014.
– reference: 23) Petruk KC, West M, Mohr G, Weir BK, Benoit BG, Gentili F, Disney LB, Khan MI, Grace M, Holness RO, Karwon MS, Ford RM, Cameron GS, Tucker WS, Purves GB, Miller JDR, Hunter KM, Richard MT, Durity FA, Chan R, Clein LJ, Maroun FB, Godon A : Nimodipine treatment in poor-grade aneurysm patients : results of a multicenter double-blind placebo-controlled trial. J Neurosurg 68 : 505-517, 1988.
– reference: 21) Marigold R, Günther A, Tiwari D, Kwan J : Antiepileptic drugs for the primary and secondary prevention of seizures after subarachnoid haemorrhage. Cochrane Database Syst Rev 6 : Cd008710, 2013.
– reference: 33) Zarbock SD, Steinke D, Hatton J, Magnuson B, Smith KM, Cook AM : Successful enteral nutritional support in the neurocritical care unit. Neurocrit Care 9 : 210-216, 2008.
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Snippet 重症くも膜下出血 (SAH) 患者の転帰は依然, 不良である. 良好な転帰を得る可能性を高めるためには, 新たな脳損傷を加えることなく早期に脳動脈瘤に対する根治術を施行する必要があるが, 同時にさまざまな全身性合併症の治療, 早期脳損傷を伴う頭蓋内圧亢進に対する迅速な管理,...
SourceID jstage
SourceType Publisher
StartPage 109
SubjectTerms delayed cerebral ischemia
early brain injury
epilepsy
subarachnoid hemorrhage
systemic complication
Title 重症くも膜下出血に対する治療
URI https://www.jstage.jst.go.jp/article/jcns/29/2/29_109/_article/-char/ja
Volume 29
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ispartofPNX 脳神経外科ジャーナル, 2020, Vol.29(2), pp.109-115
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