臨床検査54巻12号

2010年11月発行

今月の主題 脳卒中 各論

くも膜下出血診療に必要な臨床検査

著者： 中村元¹ 藤中俊之¹ 吉峰俊樹¹

所属機関： ¹大阪大学医学部脳神経外科

ページ範囲：P.1522 - P.1529

　くも膜下出血は脳だけではなく，呼吸・循環器系統を含めた全身臓器にも大きな影響を及ぼす．出血源の精査や脳血管攣縮の早期発見のために放射線学的検査が必須であることは言うまでもないが，くも膜下出血の重症度や全身合併症を的確に把握するには，血液検査を含めた各種臨床検査について熟知する必要がある．

参考文献

1) Kassell NF, Torner JC, Haley EC Jr, et al:The international cooperative study on the timing of aneurysm surgery. Part 1:overall management results. J Neurosurg　73：18-36，1990

2) Kangasniemi M, Makela T, Koskinen S, et al:Detection of intracranial aneurysms with two-dimensional and three-dimensional multislice helical computed tomographic angiography. Neurosurgery　54：336-340，2004

3) Wintermark M, Uske A, Chalaron M, et al:Multislice computerized tomography angiography in the evaluation of intracranial aneurysms:a comparison with intraarterial digital subtraction angiography. J Neurosurg　98：828-836，2003

4) Chappell ET, Moure FC, Good MC:Comparison of computed tomographic angiography with digital subtraction angiography in the diagnosis of cerebral aneurysms:a meta-analysis. Neurosurgery　52：624-631，2003

5) Matsumoto M, Sato M, Nakano M, et al:Three-dimensional computerized tomography angiography-guided surgery of acutely ruptured cerebral aneurysms. J Neurosurg　94：718-727，2001

6) 佐藤正憲，遠藤雄司，松本正人，他：Three-dimensional CT angiographyによる急性期破裂脳動脈瘤手術．脳神外ジャーナル　10：18-26，2001

7) Mitchell P, Wilkinson ID, Hoggard N, et al:Detection of subarachnoid haemorrhage with magnetic resonance imaging. J Neurol Neurosurg Psychiatry　70：205-211，2001

8) Ogawa T, Inugami A, Shimosegawa E, et al:Subarachnoid hemorrhage:evaluation with MR imaging. Radiology　186：345-351，1993

9) Huston J 3rd, Nichols DA, Luetmer PH, et al:Blinded prospective evaluation of sensitivity of MR angiography to known intracranial aneurysms:importance of aneurysm size. AJNR Am J Neuroradiol　15：1607-1614，1994

10) Ronkainen A, Puranen MI, Hernesniemi JA, et al:Intracranial aneurysms:MR angiographic screening in 400 asymptomatic individuals with increased familial risk. Radiology　195：35-40，1995

11) Schwartz RB, Tice HM, Hooten SM, et al:Evaluation of cerebral aneurysms with helical CT:correlation with conventional angiography and MR angiography. Radiology　192：717-722，1994

12) Okahara M, Kiyosue H, Yamashita M, et al:Diagnostic accuracy of magnetic resonance angiography for cerebral aneurysms in correlation with 3D-digital subtraction angiographic images:a study of 133 aneurysms. Stroke　33：1803-1808，2002

13) Sankhla SK, Gunawardena WJ, Coutinho CM, et al:Magnetic resonance angiography in the management of aneurysmal subarachnoid haemorrhage:a study of 51 cases. Neuroradiology　38：724-729，1996

14) Jager HR, Mansmann U, Hausmann O, et al:MRA versus digital subtraction angiography in acute subarachnoid haemorrhage:a blinded multireader study of prospectively recruited patients. Neuroradiology　42：313-326，2000

15) Raaymakers TW, Buys PC, Verbeeten B Jr, et al:MR angiography as a screening tool for intracranial aneurysms:feasibility, test characteristics, and interobserver agreement. AJR Am J Roentgenol　173：1469-1475，1999

16) Cloft HJ, Joseph GJ, Dion JE:Risk of cerebral angiography in patients with subarachnoid hemorrhage, cerebral aneurysm, and arteriovenous malformation:a meta-analysis. Stroke　30：317-320，1999

17) Saitoh H, Hayakawa K, Nishimura K, et al:Rerupture of cerebral aneurysms during angiography. AJNR Am J Neuroradiol　16：539-542，1995

18) Yasui T, Kishi H, Komiyama M, et al:Very poor prognosis in cases with extravasation of the contrast medium during angiography. Surg Neurol　45：560-564，1996

19) Komiyama M, Tamura K, Nagata Y, et al:Aneurysmal rupture during angiography. Neurosurgery　33：798-803，1993

20) Fountas KN, Tasiou A, Kapsalaki EZ, et al:Serum and cerebrospinal fluid C-reactive protein levels as predictors of vasospasm in aneurysmal subarachnoid hemorrhage. Clinical article. Neurosurg Focus　26：E22，2009

21) 佐藤章：重症くも膜下出血急性期の病態と治療．脳神外ジャーナル　7：24-31，1998

22) 佐藤章，中村弘，小林繁樹，他：重症くも膜下出血急性期治療における頭蓋内及び全身的複合病態の意義．脳卒中の外　32：97-102，2004

23) Wada A, Tsutamato T, Maeda Y, et al:Endogenous atrial natriuretic peptide inhibits endothelin-1 secretion in dogs with severe congestive heart failure. Am J Physiol　270：H1819-1824，1996

24) Wijdicks EF, Schievink WI, Burnett JC Jr:Natriuretic peptide system and endothelin in aneurysmal subarachnoid hemorrhage. J Neurosurg　87：275-280，1997

25) Tomida M, Muraki M, Uemura K, et al:Plasma concentrations of brain natriuretic peptide in patients with subarachnoid hemorrhage. Stroke　29：1584-1587，1998

26) 小笠原邦昭，木内博之，長嶺義秀，他：くも膜下出血におけるNaバランス―症候性脳血管攣縮との関連で．脳卒中の外　24：215-220，1996

27) 森永一生，林征志，松本行弘，他：くも膜下出血後の低Na血症と脳血管攣縮．脳と神経　44：629-632，1992

28) Ilveskero S, Juvela S, Siironen J, et al:D-dimer predicts outcome after aneurysmal subarachnoid hemorrhage:no effect of thromboprophylaxis on coagulation activity. Neurosurgery　57：16-24，2005

29) Fabinyi G, Hunt D, McKinley L:Myocardial creatine kinase isoenzyme in serum after subarachnoid haemorrhage. J Neurol Neurosurg Psychiatry　40：818-820，1977

30) Parekh N, Venkatesh B, Cross D, et al:Cardiac troponin I predicts myocardial dysfunction in aneurysmal subarachnoid hemorrhage. J Am Coll Cardiol　36：1328-1335，2000

31) Hoff JT, Nishimura M, Garcia-Uria J, et al:Experimental neurogenic pulmonary edema. Part 1:The role of systemic hypertension. J Neurosurg　54：627-631，1981

32) Schell AR, Shenoy MM, Friedman SA, et al:Pulmonary edema associated with subarachnoid hemorrhage. Evidence for a cardiogenic origin. Arch Intern Med　147：591-592，1987

33) 保坂泰昭，畑下鎮男，古賀信憲，他：重症くも膜下出血に伴う急性肺水腫24例の臨床的検討．脳卒中の外　17：139-143，1989

34) Brouwers PJ, Wijdicks EF, Hasan D, et al:Serial electrocardiographic recording in aneurysmal subarachnoid hemorrhage. Stroke　20：1162-1167，1989

35) Stober T, Anstatt T, Sen S, et al:Cardiac arrhythmias in subarachnoid haemorrhage. Acta Neurochir (Wien)　93：37-44，1988

36) Andreoli A, di Pasquale G, Pinelli G, et al:Subarachnoid hemorrhage:frequency and severity of cardiac arrhythmias. A survey of 70 cases studied in the acute phase. Stroke　18：558-564，1987

37) 山本紳一郎，増田卓，松山斉久，他：クモ膜下出血急性期に認められる心電図異常と心筋障害及び交感神経系活動との関係．日救急医会誌　8：189-200，1997

38) Lee VH, Oh JK, Mulvagh SL, et al:Mechanisms in neurogenic stress cardiomyopathy after aneurysmal subarachnoid hemorrhage. Neurocrit Care　5：243-249，2006

39) Boecher-Schwarz HG, Ungersboeck K, Ulrich P, et al:Transcranial Doppler diagnosis of cerebral vasospasm following subarachnoid hemorrhage:correlation and analysis of results in relation to the age of patients. Acta Neurochir (Wien)　127：32-36，1994

40) Grosset DG, Straiton J, McDonald I, et al:Use of transcranial Doppler sonography to predict development of a delayed ischemic deficit after subarachnoid hemorrhage. J Neurosurg　78：183-187，1993

41) Klingelhofer J, Dander D, Holzgraefe M, et al:Cerebral vasospasm evaluated by transcranial Doppler ultrasonography at different intracranial pressures. J Neurosurg　75：752-758，1991

42) Mizuno M, Nakajima S, Sampei T, et al:Serial transcranial Doppler flow velocity and cerebral blood flow measurements for evaluation of cerebral vasospasm after subarachnoid hemorrhage. Neurol Med Chir (Tokyo)　34：164-171，1994

43) Takagi R, Hayashi H, Kobayashi H, et al:Three-dimensional CT angiography of intracranial vasospasm following subarachnoid haemorrhage. Neuroradiology　40：631-635，1998

44) Otawara Y, Ogasawara K, Ogawa A, et al:Evaluation of vasospasm after subarachnoid hemorrhage by use of multislice computed tomographic angiography. Neurosurgery　51：939-942，2002

45) Tamatani S, Sasaki O, Takeuchi S, et al:Detection of delayed cerebral vasospasm, after rupture of intracranial aneurysms, by magnetic resonance angiography. Neurosurgery　40：748-753，1997

46) Kimura T, Shinoda J, Funakoshi T:Prediction of cerebral infarction due to vasospasm following aneurysmal subarachnoid haemorrhage using acetazolamide-activated 123I-IMP SPECT. Acta Neurochir (Wien)　123：125-128，1993

47) Sarrafzadeh A, Haux D, Sakowitz O, et al:Acute focal neurological deficits in aneurysmal subarachnoid hemorrhage:relation of clinical course, CT findings, and metabolite abnormalities monitored with bedside microdialysis. Stroke　34：1382-1388，2003

48) Skjøth-Rasmussen J, Schulz M, Kristensen SR, et al:Delayed neurological deficits detected by an ischemic pattern in the extracellular cerebral metabolites in patients with aneurysmal subarachnoid hemorrhage. J Neurosurg　100：8-15，2004

49) Peerdeman SM, van Tulder MW, Vandertop WP:Cerebral microdialysis as a monitoring method in subarachnoid hemorrhage patients, and correlation with clinical events--a systematic review. J Neurol　250：797-805，2003

50) Claassen J, Peery S, Kreiter KT, et al:Predictors and clinical impact of epilepsy after subarachnoid hemorrhage. Neurology　60：208-214，2003

51) McCarron MO, Alberts MJ, McCarron P:A systematic review of Terson's syndrome:frequency and prognosis after subarachnoid haemorrhage. J Neurol Neurosurg Psychiatry　75：491-493，2004