Research Project code：0150000723
Update date：Dec. 15, 2003
Pathophysiological aspect of surgical treatment of cerebrovascular disease 1) Cerebral ischemia
1999 - 2000
Investigating Researcher (1)：
Treatment for acute occlusive vascular obstruction is achieved by the Stroke Treatment Department, and following reports are achieved on the treatment policy. At the Department, cerebral neural surgery doctors and neural inner medicine doctors form the team and the acute treatments are applied for stroke. Improvement of treatment result is intended by unification of treatment guidance. The treatment guidance for ischemic cerebral vascular obstruction is presented and existing problems are examined. The clinical disease type is diagnosed by routine achieving at acute term, CT, MRI(T2W1, DW1), and MRA. When occlusive disease is recognized at main artery, SPECT (99Tc-HMPAO) and cerebral vascular image contrast are applied. Thrombus dissolving treatment is adopted to; patient of age less then 75, CT early sign is minus, CBF lowering of side ratio of 25-75 % by SPECT, and treatment will be finished after 12 hr. from onset. Low body temperature treatment is examined for severe patients of age of lower than 70, and thrombus dissolving treatment is not adopted. Anti-platelet treatment is applied for thrombus disease, artery-to-artery embolism, and other diseases, and further reagent is used together for advanced apoplexy. After admission, evaluation for carotid artery, SPECT, Holter EKG, UCG, TEE, and the likes are applied as far as possible, clinical disease type is re-evaluated, and treatment policy for preventing recur is decided. For the case of infraction is suspected, anti-coagulation treatment is aggressively applied for even high aged patient. The uniform and adequate treatment can be applied for even acute patient at night and holiday by preparing treatment policy, and treatment is improved. However the disease cases are recognized here and there which decision of clinical case and treating policy is anxious because of many appearances of ischemic focus is recognized by MRI (DWI), and improvement of treating policy is not recognized by the existing treatment policy for hemodynamic ischemia and advancing stroke. It is considered that there is a limit by the existing treating procedure, and further revise of treating policy is necessary.
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