Miyamoto K, Tsujimoto S, Tominaga M, Takeshima T, Morimoto T, Tsunoda S, Sakaki T
Department of neurosurgery, Nara Medical University, Kashihara, Japan.
No To Shinkei. 1992 Jul;44(7):621-7.
The focal brain ischemia with disturbance of cerebral venous drainage often lead to brain edema and hemorrhagic infarction and make mortality and morbidity worse. So we tried to make sure of this fact using a middle cerebral artery (MCA) occlusion model in adult cat. The MCA was exposed by the transorbital approach and temporally obstructed by Zen's clip. We divided the animals into two groups of eight cats. One group is only MCA occlusion group (sham group) and the other in MCA occlusion with disturbance of venous drainage (VRD group). We ligated bilateral external jugular vein (EJV) and internal jugular vein (IJV) and injected embolic sources from the left EJV to obstruct the venous system of cat brain. The pressure of superior sagittal sinus was increased up to 18.7 +/- 5.3 mmHg by this method. A cranial window was made above the ectosylvian gyrus, which has poor anastomosis. The reactivity of pial arteriole and regional cerebral blood flow (rCBF) were observed through the window. And histological brain examination was also performed. The result was that the reactivity of pial arterioles was severely disturbed in VRD group. The area of cerebral infarction and edema were also significantly expanded in VRD group. Considering from these facts, when the venous drainage was disturbed, cerebral perfusion pressure relatively decrease. Because of the decrease in cerebral perfusion pressure, cerebral infarction and edema probably expand to the area so called penumbra.
伴有脑静脉引流障碍的局灶性脑缺血常导致脑水肿和出血性梗死，增加死亡率和发病率。因此，我们试图通过成年猫大脑中动脉（MCA）闭塞模型来证实这一事实。通过经眶入路暴露MCA，并用Zen氏夹暂时阻断。我们将动物分为两组，每组8只猫。一组为单纯MCA闭塞组（假手术组），另一组为伴有静脉引流障碍的MCA闭塞组（VRD组）。我们结扎双侧颈外静脉（EJV）和颈内静脉（IJV），并从左EJV注入栓塞源以阻塞猫脑的静脉系统。通过这种方法，上矢状窦压力升高至18.7±5.3 mmHg。在大脑外侧沟回上方制作一个颅窗，该区域吻合较差。通过该窗口观察软脑膜小动脉的反应性和局部脑血流量（rCBF）。并且还进行了脑组织学检查。结果显示，VRD组软脑膜小动脉的反应性严重受损。VRD组脑梗死和水肿面积也显著扩大。从这些事实来看，当静脉引流受到干扰时，脑灌注压相对降低。由于脑灌注压降低，脑梗死和水肿可能会扩展到所谓的半暗带区域。
