Bode H
Universitäts-Kinderspital Basel.
Schweiz Rundsch Med Prax. 1991 Sep 10;80(37):931-5.
Investigation of cerebral circulation represents an essential diagnostic adjunct to pediatric neurology. Doppler-sonography is presented as one of the diverse techniques to examine cerebral hemodynamics. The human cerebral circulation is controlled by autoregulatory mechanisms. Factors such as hematocrit, pulse, orthostasis and physical activity modulate the cerebral blood supply. The demand for blood depends essentially on arterial pCO2 but also on behavioural situations such as mental activity, effect of sensory stimuli or sleep. Bioelectric activity and perfusion of the central nervous system are closely linked. The cerebral perfusion in infants is characterized by a rapid increase in flow over the first couple of years to values exceeding those of adults. Disturbances of the cerebral perfusion are found in a variety of pediatric diseases. The patterns of perinatal brain damage depend on the maturity of the newborn. They are mainly sequels of impaired cerebral perfusion. In prematures periventricular leukomalacia and intracerebral hemorrhage are frequent whereas in infants at term cerebral edema and infarcts are more common. Acute hemiplegia in childhood can be of thromboembolic or vascular origin, however of etiologies different from those in adulthood. Prevention is the best treatment for disturbances of cerebral perfusion in childhood. Continuous monitoring techniques and pharmacotherapy need further clinical investigation.
脑循环研究是小儿神经病学重要的辅助诊断方法。多普勒超声检查是多种检测脑血流动力学技术之一。人体脑循环受自身调节机制控制。诸如血细胞比容、脉搏、直立位和体力活动等因素可调节脑供血。血液需求主要取决于动脉血二氧化碳分压，但也取决于行为状态，如精神活动、感觉刺激或睡眠的影响。生物电活动与中枢神经系统灌注密切相关。婴儿期脑灌注的特点是在最初几年血流迅速增加，超过成人水平。脑灌注紊乱见于多种儿科疾病。围产期脑损伤的类型取决于新生儿的成熟度。它们主要是脑灌注受损的后遗症。早产儿脑室周围白质软化和脑内出血很常见，而足月儿脑水肿和梗死更常见。儿童期急性偏瘫可能源于血栓栓塞或血管病变，但其病因与成人不同。预防是儿童期脑灌注紊乱的最佳治疗方法。连续监测技术和药物治疗需要进一步的临床研究。
