Department of Neurosurgery, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, Sichuan 610 041, P. R. China.
Neurol India. 2010 May-Jun;58(3):371-6. doi: 10.4103/0028-3886.65601.
Hydrocephalus results from inadequate passage of cerebrospinal fluid (CSF) from its point of production within the cerebral ventricles to its point of absorption into systemic circulation.
The objective of this study was to investigate the disorders of CSF absorption by arachnoid villi during the different phases of hydrocephalus.
Silicone oil was injected into the fourth ventricle of 15 canines as an experimental group. Saline solution (0.9% NaCl) was injected in another nine canines as a control group. In order to block CSF transport through the cribriform plate, an external ethmoidectomy was performed in five dogs from experimental group and three dogs from control group at three days (acute stage), two weeks (sub-acute stage), and 12 weeks (chronic stage) respectively. Tritiated water was injected into the canines' cortical subarachnoid space and blood levels were measured at intervals of 1 h, 4 h, 8 h, 16 h and 48 h respectively. Time-concentration curve of tritiated water was drafted. The area under the curve (AUC) was calculated for variance analysis and t-testing.
In the chronic group, the tritiated water concentration rose slowly to a peak at 16 h. It was significantly lower than other groups at 1h, 4h, 8h and 16 h, but was higher than other groups at 48 h. Analysis of the AUC showed significant differences among all the groups (P<0.01). There were no significant differences in the AUC between control groups, the acute group, and the sub-acute group (P>0.05); however, the AUC of the chronic group was significantly lower than other groups (P<0.05).
The CSF absorption ability of arachnoid villi is significantly damaged in a long-term state of hydrocephalus.
脑积水是由于脑室内脑脊液(CSF)从产生部位向全身循环吸收部位的流通不畅所致。
本研究旨在探讨脑积水不同阶段蛛网膜绒毛吸收 CSF 功能障碍。
将硅油注入 15 只犬的第四脑室作为实验组,将生理盐水(0.9%NaCl)注入另外 9 只犬作为对照组。为了阻断 CSF 通过筛板的转运,在实验组的 5 只犬和对照组的 3 只犬中,分别在 3 天(急性期)、2 周(亚急性期)和 12 周(慢性期)进行外筛窦切除术。将氚标记水注入犬皮质下蛛网膜下腔,分别在 1h、4h、8h、16h 和 48h 测量血药浓度。绘制氚标记水的时间-浓度曲线。计算曲线下面积(AUC)进行方差分析和 t 检验。
在慢性组,氚标记水浓度缓慢上升至 16h 达到峰值,在 1h、4h、8h 和 16h 时明显低于其他组,但在 48h 时明显高于其他组。AUC 分析显示,各组间差异有统计学意义(P<0.01)。对照组、急性期组和亚急性期组 AUC 间差异无统计学意义(P>0.05);然而,慢性组的 AUC 明显低于其他组(P<0.05)。
在长期脑积水状态下,蛛网膜绒毛的 CSF 吸收能力明显受损。