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뇌지주막하 출혈 후 뇌혈관 연축에 대한 동맥내 Papaverine 주입의 치료효과

Other Titles
 Effect of intra-arterial papaverine infusion on the symptomatic cerebral vasospasm after aneurysmal subarachnoid hemorrhage 
 신준재  ;  이재환  ;  신용삼  ;  허승곤  ;  김동익  ;  이규창 
 Journal of Korean Neurosurgical Society (대한신경외과학회지), Vol.30(3) : 325-333, 2001 
Journal Title
 Journal of Korean Neurosurgical Society (대한신경외과학회지) 
Issue Date
Subarachnoid hemorrhage ; Symptomatic vasospasm ; Intra-arterial papaverine infusion
Objective:To clarify the benefits and therapeutic effects of intra-arterial papaverine infusion on the symptomatic cerebral vasospasm, we analyzed the results of treatment in 32 patients retrospectively. Methods:A total of 510 patients underwent surgical clipping or endovascular intra-aneurysmal treatment for ruptured intracranial aneurysm between May, 1996 and June, 1999. The delayed ischemic deficit(DID) was developed in 90 of 510 patients. Of these 90 patients, 32 developed symptomatic vasospasm inspite of using modest "3H therapy". The brain CT scan was taken before the intra-arterial infusion of papaverine. The 32 patients underwent 42 intra-arterial papaverine infusion. The symptomatic vasospasm was divided into three groups:deterioration of mental status(Group 1), appearance of a focal neurologic deficit(Group 2), or both(Group 3). We measured Glasgow Coma Scale(GCS), arterial diameters, and cerebral circulation time(CCT) at the time of pre- and postangioplasty. Results:The number of patients in group 1, 2 and 3 were 26, 7, 9 respectively. Eighteen cases showed improvement of GCS more than 2 scores, 16 more than 1, and 8 showed no change of GCS. Average cerebral circulation time(CCT) was decreased ranging from 0.0-67.5%, and arterial diameters were increased in 21 cases ranging from 1 to 4 folds. Conclusion:Intra-arterial papaverine infusion seemed to have therapeutic effects on symptomatic vasospasm by improving the neurological signs and increasing the arterial diameter. We suggest that intra-arterial papaverine infusion would be an useful adjunctive therapeutic modality in symptomatic vasospasm.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dong Ik(김동익)
Shin, Jun Jae(신준재) ORCID logo https://orcid.org/0000-0002-1503-6343
Lee, Jae Whan(이재환)
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