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  1. 病院誌・年報
  2. 北海道脳神経疾患研究所医誌
  3. 17巻

脳梗塞急性期STA-MCAバイパス術後の過灌流症候群の検討

https://sapmed.repo.nii.ac.jp/records/8140
https://sapmed.repo.nii.ac.jp/records/8140
b45bce13-2151-45ac-90eb-872235860685
名前 / ファイル ライセンス アクション
n134057641713.pdf n134057641713.pdf (1.9 MB)
Item type 学術雑誌論文 / Journal Article(1)
公開日 2009-03-24
タイトル
タイトル 脳梗塞急性期STA-MCAバイパス術後の過灌流症候群の検討
言語 ja
言語
言語 jpn
キーワード
主題Scheme Other
主題 STA-MCA bypass
キーワード
言語 en
主題Scheme Other
主題 STA-MCA bypass in acute stage
キーワード
言語 en
主題Scheme Other
主題 hyperperfusion
資源タイプ
資源タイプ識別子 http://purl.org/coar/resource_type/c_6501
資源タイプ journal article
著者 渡部, 寿一

× 渡部, 寿一

渡部, 寿一

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大里, 俊明

× 大里, 俊明

大里, 俊明

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中川原, 譲二

× 中川原, 譲二

中川原, 譲二

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上山, 憲司

× 上山, 憲司

上山, 憲司

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荻野, 達也

× 荻野, 達也

荻野, 達也

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野呂, 秀策

× 野呂, 秀策

野呂, 秀策

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原, 敬二

× 原, 敬二

原, 敬二

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佐々木, 雄彦

× 佐々木, 雄彦

佐々木, 雄彦

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中村, 博彦

× 中村, 博彦

中村, 博彦

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抄録
内容記述タイプ Abstract
内容記述 Object : While there are only a handful of reports in the literature detailing hyperperfusion syndrome (HPS) occurring in the chronic stage of a brain infarction after STA-MCA bypass, there are even fewer detailing its occurrence in the acute stage. If we opt to perform an STA-MCA bypass in the acute stage to minimalize any possible extension of the lesion, it seems reasonable to assume that there is a greater risk of hyperperfusion syndrome, as the cerebral perfusion pressure is lower than that in the chronic stage. To test this assumption, we compared the incidence of hyperperfusion syndrome after STA-MCA bypasses performed in both the acute and chronic stages. Patients and Methods : Over a 4-year period, from April 1st 2002 to May 10th 2006, we performed 53 STA-MCA bypasses, 23 in the acute stage and 32 in the chronic stage. Each case was examined by IMP or Xe SPECT within 2 weeks of the bypass surgery. Where hyperperfusion was evident, cases were divided into one of two groups, according to the location of the hyperperfusion : Group A demonstrating it locally, and Group B demonstrating it hemispherically. Symptomatic cases were also divided into two groups according to the degree of severity, with the mild group exhibiting such things as headaches or transient psychological disturbance, and the severe group reporting convulsions or conscious disturbance etc. Results : Of the 23 acute stage bypasses, 7 cases (30.4%) were classified as Group A and 2 cases (8.7%) as Group B, affecting 9/23 cases, or 39.1% of the acute total. Of these, there were 3 mild symptomatic cases (13.0%), and 1 severe case (4.3%). Of the chronic stage bypasses, 4 cases (12.5%) were classified as Group A and 1 case (3.1%) as Group B, affecting 5/32 cases, or 15.6% of the chronic total. Of these, there was 1 mild symptomatic case (3.1%), and 2 severe cases (6.3%). There were no hemorrhagic transformations. According to these results, acute stage bypasses were not significantly different to chronic ones with regard to the occurrence of symptomatic cases. (p=0.435; Fisher exact method) Conclusion : There were more cases of hyperperfusion in acute stage bypasses than in chronic stage bypasses, but there was no significant difference in symptomatic rates. This implies that it may be feasible to safely perform STA-MCA bypasses in the acute stage without undue concern for the occurrence of hyperperfusion syndrome.
書誌情報 北海道脳神経疾患研究所医誌 = Journal of Hokkaido Brain Research Foundation

巻 17, 号 1, p. 3-6, 発行日 2007-03-01
ISSN
収録物識別子タイプ ISSN
収録物識別子 1340-5764
著者版フラグ
出版タイプ VoR
出版タイプResource http://purl.org/coar/version/c_970fb48d4fbd8a85
その他のタイトル
その他のタイトル Hyperperfusion Syndrome after STA-MCA Bypass in Acute Stage of Brain Infarctions
出版者
出版者 中村記念病院
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