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脑血管痉挛是蛛网膜下腔出血后常见而危险的并发症,其导致的继发性缺血性脑损害是致死致残的主要原因。目前关于蛛网膜下腔出血引起脑血管痉挛的发病机制、诊断及治疗均为研究热点,且也是临床亟待解决的问题。但关于其确切的发病机制、诊断及治疗方法均未统一,尚存在较大争议。关于其发病机制学说,主要包括气体信号分子学说和炎性反应学说;目前对其诊断主要依赖脑血管造影、CT灌注成像、经颅多普勒超声等检查方法;针对其治疗,可采用药物治疗、脑脊液引流、血管内介入治疗或基因治疗等方法。本文就近期关于蛛网膜下腔出血后脑血管痉挛的形成机制、诊断及治疗的进展进行综述。
Cerebral vasospasm is a common and dangerous complication after subarachnoid hemorrhage, leading to secondary ischemic brain damage which is the leading cause of death and disability. At present, the pathogenesis, diagnosis and treatment of cerebral vasospasm caused by subarachnoid hemorrhage are both hot spots for research and are also problems to be solved urgently in clinic. However, its exact pathogenesis, diagnosis and treatment are not uniform, there is still much controversy. About its pathogenesis, including gas theory and inflammatory response theory; currently its diagnosis depends mainly on cerebral angiography, CT perfusion imaging, transcranial Doppler ultrasound examination; for its treatment, the use of drug treatment , Cerebrospinal fluid drainage, endovascular intervention or gene therapy. This article reviews the recent progress in the pathogenesis, diagnosis and treatment of cerebral vasospasm after subarachnoid hemorrhage.