폐쇄성 뇌혈관 질환에 대한 임상적 고찰

Abstract

[영문]

[한글]

폐쇄성뇌혈관질환의 연구를 통하여 앞으로 치료방법 및 진단방법의 개선을 기하기 위해

서 1973년 부터 1980년 까지 8년동안 폐쇄성뇌혈관질환의 임상증상으로 전주예수병원 신

경외과에 입원했던 352명의 환자를 대상으로 임상적 분석 및 고찰을 하여 다음과 같은 결

과를 얻었다.

뇌혈관조영술상 병변 확인율은 50% 이었고 병변이 가장 많았던 장소는 중대뇌동맥이었

으며 좌측에서 호발하였다. 대부분의 경우 40 대에서 60대 사이에 발병했으며 남자가 여

자보다 3.2배 많았다.

위험 인자로는 고혈압, 심장병, 당뇨병등의 순서로 많았다. 고혈압의 빈도는 폐쇄성뇌

졸중의 호발 연령과는 일치하였지만 혈중 cholesterol 치와는 상관 관계가 없었다.

치료의 성적은 보존적 요법으로 치료했던 군이 수술적 요법으로 치료했던 군보다 좋았

으나 실제로 두군간의 치료결과를 비교하기는 어려웠다.

뇌전산화단층촬영 및 국소뇌혈류측정등에 의하여 적응만 잘 결정한다면 수술에 의한 효

과는 보다더 좋아 지리라고 생각된다.

A Clinical Analysis of Occlusive Cerebrovascular Disease

Han Kyu Kim

Department of Medical Science The Graduate School Yonsei University

(Directed by Prof. Kyu Chang Lee, M.D.)

The author analyzed 352 patients who had been admitted to Presbyterian Medical

Center with clinical signs and symptoms of occlusive stroke from 1973 to 1980.

Cerebral angiography was performed on 250 patients and 126 patients(50%) of them

were confirmed to have angiographic evidence of occlusion. We've analyzed these 126

patients in clinical point of view. The location of the lesion was most common at

the middle cerebral artery, and the site of predilection was the left. In majority

of cases, the occlusive stroke was occurred in age group of 5th to 7th decade, and

man was 3.2 times as common as woman. Risk factors were hypertension, cardiac

problems, diabetes and so on. Hypertension, the most common risk factor, correlated

well to the peak age incidence, but there was not anyintimate relationship with the

level of serum cholesterol.

The outcome of medically treated group (112 patients) was somewhat better than

surgery(14 patients). Among 12 of extracranial-intracranial arterial bypass

surgery, transientischemic attack noted the best result compared to reversible

ischemic neurological deficit and stroke in evolution. Meticulous selection of

patients using CT scanning and measurement of regional cerebral blood flow would

promote the benefit of surgery.