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[皮质下蛛网膜下腔出血对脑葡萄糖代谢的影响]

[Effects of the cortical subarachnoid hemorrhage on cerebral glucose metabolism].

作者信息

Ito C, Yamaura A, Ozawa Y, Murai H, Wagai N, Nakamura T, Makino H

机构信息

Department of Neurological Surgery, Chiba University School of Medicine, Japan.

出版信息

No To Shinkei. 1991 Jan;43(1):30-6.

PMID:2054220
Abstract

Neurological deficits following human subarachnoid hemorrhage (SAH) have been related to the cerebral arterial spasm and the increase in intracranial pressure (ICP) secondary to the development of hydrocephalus. Metabolic depression in experiment study was thought as resulting from brain stem dysfunction. On the other hand, some reports have shown no relationship between vasospasm and neurological abnormalities. The mechanism of cerebral metabolism depression after SAH remains unclear. The effect of blood in the cortical subarachnoid space on the cerebral metabolism has not been known well. To investigate this effect, a new cortical SAH model was developed using rat and local cerebral glucose utilization (LCGU) after production of SAH was measured. A cortical SAH model: a small burr hole was made on the left parietal bone and the arachnoid membrane was pierced with a tapered glass-needle 60 mu tip in diameter. Fresh autologous non-heparinized arterial blood 0.04 ml was injected into subarachnoid space within 60 seconds through that needle. The blood extended over the left cerebral cortical surface with thin subarachnoid hematoma on the parietal cortex, but did not extend on the right hemisphere and the basal cistern. The increase in ICP during production of SAH was minimal, mean value of 7.2 mmHg and ICP slowly returned to the basal level within 30 minutes. Rats were divided into 3 groups; rats 2 hours (SAH-2h, n = 7) and 48 hours (SAH-48h, n = 7) after production of SAH and rats 2hours after 0.04 ml saline injection for control (Control, n = 7). LCGU was studied according to the methods developed by Sokoloff.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

人类蛛网膜下腔出血(SAH)后的神经功能缺损与脑动脉痉挛以及脑积水形成继发的颅内压(ICP)升高有关。实验研究中的代谢抑制被认为是脑干功能障碍所致。另一方面,一些报告显示血管痉挛与神经异常之间并无关联。SAH后脑代谢抑制的机制仍不清楚。皮质蛛网膜下腔中的血液对脑代谢的影响尚不明确。为研究这种影响,利用大鼠建立了一种新的皮质SAH模型,并在SAH形成后测量局部脑葡萄糖利用(LCGU)。皮质SAH模型:在左顶骨上钻一个小骨孔,用直径60微米的锥形玻璃针穿刺蛛网膜。通过该针在60秒内将0.04毫升新鲜自体非肝素化动脉血注入蛛网膜下腔。血液在左脑皮质表面蔓延,顶叶皮质有薄层蛛网膜下腔血肿,但未蔓延至右半球和基底池。SAH形成过程中ICP的升高极小。平均为7.2 mmHg,ICP在30分钟内缓慢恢复至基础水平。大鼠分为3组;SAH后2小时(SAH - 2h,n = 7)和48小时(SAH - 48h,n = 7)的大鼠,以及注射0.04毫升生理盐水作为对照2小时后的大鼠(对照,n = 7)。根据Sokoloff开发的方法研究LCGU。(摘要截断于250字)

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