Burger Ralf, Bendszus Martin, Vince Giles Hamilton, Solymosi Laszlo, Roosen Klaus
Department of Neurosurgery, University of Regensburg, Regensburg, Germany.
Neurosurgery. 2004 Mar;54(3):701-11; discussion 711-2. doi: 10.1227/01.neu.0000108784.80585.ee.
To assess the effects of moderate intraischemic hypothermia on neurophysiological parameters in an epidural balloon compression model in rats and to correlate the results with magnetic resonance imaging and histological findings.
Neurophysiological monitoring included laser Doppler flow, tissue partial oxygen pressure, and intracranial pressure measurements and electroencephalographic assessments during balloon expansion, sustained inflation, and reperfusion. Moderate intraischemic cooling of animals was extended throughout the reperfusion period, and results were compared with those for normothermic animals. Moreover, histological morphometric and magnetic resonance imaging volumetric analyses of the lesions were performed.
Laser Doppler flow decreased slightly during ischemia (P < 0.05) in animals treated with hypothermia, and flow values demonstrated complete reperfusion, compared with incomplete flow restoration in untreated animals (P < 0.05). During ischemia, the tissue partial oxygen pressure was less than 4.3 mm Hg in both groups. After reperfusion, values returned to the normal range in both groups, but the tissue partial oxygen pressure in hypothermic animals was significantly higher (P = 0.042) and demonstrated 19% higher values, compared with normothermic animals, before rewarming. Moderate hypothermia attenuated a secondary increase in intracranial pressure (P < 0.05), and electroencephalographic findings indicated a trend toward faster recovery (P > 0.05) after reperfusion. Lesion size was reduced by 35% in magnetic resonance imaging volumetric evaluations and by 24.5% in histological morphometric analyses.
Intraischemic hypothermia improves cerebral microcirculation, attenuates a secondary increase in intracranial pressure, facilitates electroencephalographic recovery, and reduces the lesion size.
评估中度缺血性低温对大鼠硬膜外球囊压迫模型神经生理参数的影响,并将结果与磁共振成像和组织学结果相关联。
神经生理监测包括激光多普勒血流、组织局部氧分压、颅内压测量以及球囊扩张、持续充气和再灌注期间的脑电图评估。动物在整个再灌注期进行中度缺血性降温,并将结果与正常体温动物的结果进行比较。此外,对病变进行了组织学形态计量和磁共振成像体积分析。
低温治疗的动物在缺血期间激光多普勒血流略有下降(P < 0.05),与未治疗动物血流恢复不完全相比,血流值显示完全再灌注(P < 0.05)。在缺血期间,两组的组织局部氧分压均低于4.3 mmHg。再灌注后,两组的值均恢复到正常范围,但低温动物的组织局部氧分压显著更高(P = 0.042),与正常体温动物相比,在复温前高19%。中度低温减轻了颅内压的二次升高(P < 0.05),脑电图结果表明再灌注后有更快恢复的趋势(P > 0.05)。磁共振成像体积评估中病变大小减少了35%,组织学形态计量分析中减少了24.5%。
缺血性低温可改善脑微循环,减轻颅内压的二次升高,促进脑电图恢复,并减小病变大小。