Vorkapic P, Bevan J A, Bevan R D
Department of Neurosurgery, University of Vienna Medical School, Austria.
Neurosurg Rev. 1991;14(3):215-9. doi: 10.1007/BF00310660.
Subarachnoid hemorrhage (SAH) was induced by multiple injections of autologous blood into the prepontine cistern in the rabbit. Long-lasting angiographic narrowing was recorded over a period of nine days after SAH. Papaverine (PPV) reversed angiographic narrowing in the first three days after SAH. Vasospasm was refractory to PPV from day five to day nine after SAH. PPV - refractoriness (in vivo) was positively correlated with decreased vessel wall distensibility (in vitro). Arterial segments showed spontaneous increases in tone in the first two days after SAH. Other alterations observed include a marked gradual reduction in the capacity of the vessel wall to contract, reduction in constrictor nerve influences on vascular tone, and impaired acetylcholine - induced vasorelaxation. Tonic contraction to the maximum dose of serotonin was increased in acute spasm and decreased in chronic spasm. It is suggested that the initial cause of arterial narrowing after SAH is the action of vasoactive substances released in the close vicinity of the arterial wall; this then leads to abnormal tone, tissue damage, and structural changes.
通过向兔脑桥前池多次注射自体血诱导蛛网膜下腔出血(SAH)。SAH后九天内记录到持续的血管造影狭窄。罂粟碱(PPV)在SAH后的前三天可逆转血管造影狭窄。SAH后第五天至第九天,血管痉挛对PPV难治。PPV难治性(体内)与血管壁扩张性降低(体外)呈正相关。SAH后前两天,动脉节段出现自发性张力增加。观察到的其他改变包括血管壁收缩能力明显逐渐降低、缩血管神经对血管张力的影响降低以及乙酰胆碱诱导的血管舒张受损。急性痉挛时对最大剂量5-羟色胺的强直性收缩增加,慢性痉挛时则降低。提示SAH后动脉狭窄的初始原因是动脉壁附近释放的血管活性物质的作用;这随后导致异常张力、组织损伤和结构变化。