To discuss the mechanism of cerebra l vessel spasm caused by concussion and the effect of Nimodipine on concussion. Methods: A total of 224 patients who were treated from March 1 995 to October 1999 were divided into ...To discuss the mechanism of cerebra l vessel spasm caused by concussion and the effect of Nimodipine on concussion. Methods: A total of 224 patients who were treated from March 1 995 to October 1999 were divided into two groups randomly, ie, Nimodipine group (113 cases) and control group (111 cases). Middle cerebral artery (MCA), basila r artery (BA) and the average peak forward velocity of cerebral blood flow were observed by color three dimensional transcranial Doppler (3D TCD) within 24 ho urs after admission and at the end of 3 6 days of treatment. Cerebral blood flo w changes, characteristics and treatment effect were analyzed and determined by clinical main symptom disappearance rate. Results: In concussion, cerebral blood flow was divided into 3 phases: cerebral blood flow low infusion dilation phase, cerebral blood vessel s pasm phase and cerebral blood flow recovery phase. In the Nimodipine group, clin ical main symptom disappearance rate was higher than that in the control group i n the cerebral spasm and recovery phases with a significant difference (P< 0.01 ). Conclusions: Cerebral vessel spasm, hypoxia and ischemia lesion are the main pathological changes. Whether cerebral dysfunction is reversible o r not is mainly determined by spasm time of cerebral blood vessel. Nimodipine ha s a good effect on releasing spasm and diminishing the cerebral blood flow veloc ity. It not only improves curative effect on concussion, but also reduces and pr events concussion sequelae. Hence, concussion patients who have cerebral spasm c onfirmed by 3D TCD should be given Nimodipine routinely and early.展开更多
文摘To discuss the mechanism of cerebra l vessel spasm caused by concussion and the effect of Nimodipine on concussion. Methods: A total of 224 patients who were treated from March 1 995 to October 1999 were divided into two groups randomly, ie, Nimodipine group (113 cases) and control group (111 cases). Middle cerebral artery (MCA), basila r artery (BA) and the average peak forward velocity of cerebral blood flow were observed by color three dimensional transcranial Doppler (3D TCD) within 24 ho urs after admission and at the end of 3 6 days of treatment. Cerebral blood flo w changes, characteristics and treatment effect were analyzed and determined by clinical main symptom disappearance rate. Results: In concussion, cerebral blood flow was divided into 3 phases: cerebral blood flow low infusion dilation phase, cerebral blood vessel s pasm phase and cerebral blood flow recovery phase. In the Nimodipine group, clin ical main symptom disappearance rate was higher than that in the control group i n the cerebral spasm and recovery phases with a significant difference (P< 0.01 ). Conclusions: Cerebral vessel spasm, hypoxia and ischemia lesion are the main pathological changes. Whether cerebral dysfunction is reversible o r not is mainly determined by spasm time of cerebral blood vessel. Nimodipine ha s a good effect on releasing spasm and diminishing the cerebral blood flow veloc ity. It not only improves curative effect on concussion, but also reduces and pr events concussion sequelae. Hence, concussion patients who have cerebral spasm c onfirmed by 3D TCD should be given Nimodipine routinely and early.
