Sakuta O, Mukawa J
Department of Neurosurgery, University of the Ryukyus, School of Medicine, Okinawa, Japan.
No Shinkei Geka. 1991 Jul;19(7):625-31.
Effects of extracerebral compression on cerebral circulation and microvascular architectures were investigated in 23 adult cats. Brain compression was produced by inserting 12 steel balls (5 mm in diameter) into the extradural space through a burr hole at the left temporal bone. One ball was inserted every 10 minutes. Mean arterial blood pressure (MABP), intracranial pressure (ICP) and cerebral blood flow (CBF) were measured continuously. Cerebral perfusion pressure (CPP) and cerebrovascular resistance (CVR) were then calculated. Microvascular architectures of the brain were studied by scanning electron microscopy (SEM) with cerebrovascular casting methods. CBF decreased significantly on the compressed side though CPP remained unchanged till 5 balls had been inserted. CVR increased correlatively to the numbers of balls on the compressed side while remaining unchanged during insertion of the balls on the contralateral side. In SEM study, flection and interruption of capillaries and compressed phenomenon of veins were most remarkable on the compressed side. Alterations of microvascular architectures correspond to cortical deformity in degree. These data show that increase of CVR correlating to alteration of microvascular architectures plays an important role in decrease of CBF in a compressed brain. It is thus suggested that intracranial mass lesion causing deformity of the brain must be removed in order to avoid further brain tissue damage due to microvascular lesions.
在23只成年猫身上研究了脑外压迫对脑循环和微血管结构的影响。通过在左颞骨处钻骨孔将12个钢球（直径5毫米）插入硬膜外间隙来产生脑压迫。每隔10分钟插入一个球。连续测量平均动脉血压（MABP）、颅内压（ICP）和脑血流量（CBF）。然后计算脑灌注压（CPP）和脑血管阻力（CVR）。采用脑血管铸型法通过扫描电子显微镜（SEM）研究脑的微血管结构。在插入5个球之前，尽管CPP保持不变，但受压侧的CBF显著下降。CVR与受压侧球的数量相关增加，而在对侧插入球的过程中保持不变。在SEM研究中，受压侧毛细血管的弯曲和中断以及静脉的受压现象最为明显。微血管结构的改变在程度上与皮质畸形相对应。这些数据表明，与微血管结构改变相关的CVR增加在受压脑的CBF降低中起重要作用。因此建议必须去除导致脑畸形的颅内占位性病变，以避免因微血管病变导致进一步的脑组织损伤。
