Journal of Korean Neurosurgical Society
- 제29권12호
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- Pages.1563-1569
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- 2000
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- 2005-3711(pISSN)
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- 1598-7876(eISSN)
뇌동맥류 파열에 의한 뇌지주막하 출혈후 혈관 조영상 혈관연축과 임상적 혈관연축의 상관관계
Correlation between Angiographic Vasospasm and Clinical Vasospasm following Aneurysmal Subarachnoid Hemorrhage
- 서동상 (순천향대학교 의과대학 신경외과학교실) ;
- 김범태 (순천향대학교 의과대학 신경외과학교실) ;
- 임수빈 (순천향대학교 의과대학 신경외과학교실) ;
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조성진
(순천향대학교 의과대학 신경외과학교실) ;
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신원한
(순천향대학교 의과대학 신경외과학교실) ;
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최순관
(순천향대학교 의과대학 신경외과학교실) ;
- 변박장 (순천향대학교 의과대학 신경외과학교실)
- Suh, Dong-Sang (Department of Neurosurgery, College of Medicine, Soonchunhyang University) ;
- Kim, Bum-Tae (Department of Neurosurgery, College of Medicine, Soonchunhyang University) ;
- Im, Soo-Bin (Department of Neurosurgery, College of Medicine, Soonchunhyang University) ;
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Cho, Sung-Jin
(Department of Neurosurgery, College of Medicine, Soonchunhyang University) ;
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Shin, Won-Han
(Department of Neurosurgery, College of Medicine, Soonchunhyang University) ;
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Choi, Soon-Kwan
(Department of Neurosurgery, College of Medicine, Soonchunhyang University) ;
- Byun, Bark-Jang (Department of Neurosurgery, College of Medicine, Soonchunhyang University)
- 투고 : 1999.12.13
- 심사 : 2000.09.25
- 발행 : 2000.12.28
초록
Objective : Delayed ischemic neurologic deficit(DIND) is one of the major complications following aneurysmal subarachnoid hemorrhage(SAH). However, the correlation between angiographic vasospasm(AV) and DIND after SAH is not precisely known. The authors investigated the timing, incidence, characteristics of DIND, and analyzed correlation between AV and DIND. Patients and Methods : A series of 126 patients with SAH and performed cerebral angiography which, confirmed anterior circulation aneurysm, admitted to between January 1996 to December 1998, were studied retrospectively. A comparative analysis between group 1(G1) in which AV patients presented with DIND, and group 2(G2) patients did not DIND, were done. AV was graded according to location, distribution and degree. Location of vasospasm was classified as basal type(BT), distal type(DT). BT was involved horizontally and include the bilateral carotid systems, proximal middle cerebral artery(MCA) and proximal anterior cerebral artery(ACA). DT was involved vertically and include the MCA branches as they become vertically or posteriorly oriented and the ACA distal to the anterior communicating artery. BT and DT all defined ether as localized type(LT) or combined type(CT). Distribution of vasospasm was classified as type I, type II and type III. Type I represents the involvement of bilateral carotid systems and bilateral anterior cerebral artery, type II was designed as one carotid system without involving anterior cerebral artery, and type III when only some portions of the anterior cerebral artery were involved, bilaterally. Degree of vasospasm was classified as mild(less than 25%), moderate(between 25-50%), severe(greater than 50%), and those were determined by comparing the caliber of the artery in vasospasm to that of the nearest area of apparently normal vessel. Results : The incidence of AV & DIND was 57/126(45.2%), 29/126(23.0%), and timing of DIND was 9 days(