脑动脉瘤破裂出血经颅多普勒动态研究

Transcranial Doppler ultrasound:Study on the hemorrhage of cerebral aneurysm.

应用经颅超声多普勒研究１５例经脑血管造影证实的脑动脉瘤破裂出血患者的脑循环动态改变。１２例出现不同程度的血管痉挛，以出血侧大脑中动脉为主，８～１４天达高峰。此１２例均行手术夹闭动脉瘤，术前１～３天血流速度在８１～１３０ＣＭ／Ｓ，预后好。余３例表现严重颅内压升高和脑部低灌注的患者未行手术，均死亡。表明经颅多普勒能及时发现血管痉挛，同时反映颅内压和脑灌注的变化，对选择手术时机和判断临床预后有重要意义。

AbstractTranscranial Doppler ultrasound(TCD)was used to study the serial changes of cerebral cir-culation in 15 patients with hemorrhage after aneurysmal rupture.A marked increase of flow ve-locity of the middle cerebral artery was found in 12 operated patients within 8～ 14 days after on-set.Velocities reached maximum value about 200 cm/s,and then declined.The patients whosemean flow velocity was 84～130 cm/s before operation had good prognosis.Increased intracra-nial pressure and cerebral hypoperfusion were observed in three patients by TCD,and they died in two weeks.The results indicate that TCD is a reliable and convenient noninvasive method for mon-itoring the change of cerebral vasocpasm,intracranial pressure and cerebral blood perfusion,which provides important clinical in formation concerning choice of the time of operation and clinical prognosis.