Uhl E, Wrba E, Nehring V, Chang R C, Baethmann A, Reulen H J
Department of Neurosurgery, Grosshadern University Hospital, Ludwig-Maximilians-University Munich, Germany.
Acta Neurochir (Wien). 1999;141(1):89-92. doi: 10.1007/s007010050270.
The aim of the current study was to develop an experimental animal model for quantitative analysis of oedema resolution via the subarachnoid space and the ventricular system using fluorescent oedema markers.
Artificial cerebrospinal fluid (CSF) containing TRITC-albumin (MW 67.000D) and Na(+)-fluorescein (MW 376D) was continuously infused into the white matter of the left frontal lobe of New Zealand white rabbits (n = 6) at a rate of 100 microliters/h for 3 hrs. A closed cranial window for superfusion of the brain surface with artificial CSF fluid (3 ml/h) was implanted above the left parietal cortex for measurement of the fluorescence markers in the subarachnoid space. Uptake of the fluorescence indicators into the ventricles was quantified by ventriculo-cisternal perfusion (3 ml/h). The effluates were collected at 30 min intervals for 3 hrs after the start of infusion. Clearance of the oedema fluid into the perfusates was measured by fluorescence spectrophotometry.
At an intracranial pressure of 15.0 +/- 1.7 mm Hg (mean +/- SEM) both indicators started to accumulate in the subarachnoid and ventricular perfusates at 90 min following onset of oedema fluid infusion. The concentrations of the indicators in the ventricular system increased to 7.7 +/- 5.1% of Na(+)-fluorescein and 16.1 +/- 13.0% of TRITC-albumin of the total amount infused were recovered in the ventricular system at 3 hours after start of the oedema infusion, while 3.4 +/- 3.2% of Na(+)-fluorescein and 3.7% +/- 3.2 of TRITC-albumin, respectively, were found in the effluates of the subarachnoid space.
The present study demonstrates that resolution of vasogenic brain oedema into the cerebral ventricular system and the subarachnoid space following its entry into cerebral white matter can be quantitatively analysed using fluorescence markers, which serve as oedema fluid indicators. The results indicate that the oedema fluid is cleared not only into the ventricular system but also via the subarachnoid space.
本研究的目的是建立一种实验动物模型，用于使用荧光水肿标记物通过蛛网膜下腔和脑室系统对水肿消退进行定量分析。
将含有TRITC-白蛋白（分子量67,000D）和Na(+)-荧光素（分子量376D）的人工脑脊液（CSF）以100微升/小时的速度持续注入新西兰白兔（n = 6）左额叶白质中，持续3小时。在左顶叶皮质上方植入一个封闭的颅窗，用于用人造脑脊液（3毫升/小时）对脑表面进行灌流，以测量蛛网膜下腔中的荧光标记物。通过脑室-脑池灌注（3毫升/小时）对荧光指示剂进入脑室的情况进行定量。在输注开始后3小时内，每隔30分钟收集一次流出液。通过荧光分光光度法测量水肿液进入灌流液中的清除情况。
在颅内压为15.0±1.7毫米汞柱（平均值±标准误）时，在水肿液输注开始后90分钟，两种指示剂开始在蛛网膜下腔和脑室灌流液中积累。在水肿输注开始3小时后，脑室系统中指示剂的浓度分别增加到注入总量的Na(+)-荧光素的7.7±5.1%和TRITC-白蛋白的16.1±13.0%，而在蛛网膜下腔的流出液中分别发现了3.4±3.2%的Na(+)-荧光素和3.7%±3.2的TRITC-白蛋白。
本研究表明，血管源性脑水肿进入脑白质后进入脑室系统和蛛网膜下腔的消退情况可以使用荧光标记物进行定量分析，这些荧光标记物可作为水肿液指示剂。结果表明，水肿液不仅被清除到脑室系统中，还通过蛛网膜下腔清除。
