Karadağ O, Eroğlu E, Gürelik M, Göksel H M, Kiliç E, Gültürk S
Department of Neurosurgery, Cumhuriyet University, School of Medicine, Sivas, Turkey.
Acta Neurochir (Wien). 2005 Jan;147(1):79-84; discussion 84. doi: 10.1007/s00701-004-0410-5.
Cerebral microcirculatory changes during cerebral vasospasm after aneurysmal subarachnoid haemorrhage (SAH) are still controversial and uncertain. The aim of our study is to demonstrate that spinal cord stimulation (SCS) augments cerebral cortical microcirculatory blood flow in an experimental cerebral vasospasm model by using Laser Doppler Flowmetry (LDF).
The experiments were carried out on 24 New Zealand rabbits. Three experimental groups were designed. In group 1, Cerebral cortical blood flow (CCoBF) was evaluated by LDF in 8 rabbits. In group 2, Intracisternal saline injection and cervical epidural electrode placement without SCS were performed in 8 animals before LDF. In group 3, LDF was performed before and after SCS on the 4th day of SAH in 8 rabbits. CCoBF parameters obtained from LDF data were compared.
The occurrence of vasospasm after SAH was demonstrated with significant changes in LDF values. In all SAH animals, SCS resulted in significant increase (approximately 30%) in CCoBF. This increase was observed to continue even after the cessation of the stimulation.
These results indicate that SCS improves cortical ischemia due to vasospasm after induced SAH. The cervical SCS may constitute a new therapeutic modality in treating disturbed CCoBF due to vasospasm.
动脉瘤性蛛网膜下腔出血(SAH)后脑血管痉挛期间的脑微循环变化仍存在争议且尚不明确。我们研究的目的是通过激光多普勒血流仪(LDF)在实验性脑血管痉挛模型中证明脊髓刺激(SCS)可增加大脑皮质微循环血流量。
对24只新西兰兔进行实验。设计了三个实验组。在第1组中,用LDF评估8只兔的大脑皮质血流量(CCoBF)。在第2组中,8只动物在进行LDF之前进行脑池内注射生理盐水和放置颈段硬膜外电极但不进行SCS。在第3组中,对8只兔在SAH第4天进行SCS前后进行LDF检测。比较从LDF数据获得的CCoBF参数。
SAH后血管痉挛的发生通过LDF值的显著变化得以证实。在所有SAH动物中,SCS导致CCoBF显著增加(约30%)。即使在刺激停止后,这种增加仍持续存在。
这些结果表明SCS可改善SAH诱导后因血管痉挛导致的皮质缺血。颈段SCS可能构成一种治疗因血管痉挛导致的CCoBF紊乱的新治疗方式。