King's College London, Department of Clinical Neuroscience, Institute of Psychiatry, London, UK.
J Cereb Blood Flow Metab. 2012 Feb;32(2):201-2. doi: 10.1038/jcbfm.2011.170. Epub 2011 Dec 7.
There are longstanding inconsistencies in the evidence thought to link vasospasm in the major branches of the Circle of Willis with delayed cerebral ischemia and poor outcome from aneurysmal subarachnoid hemorrhage (aSAH). The demonstrations, first in the laboratory, and more recently in patients with aSAH, of cortical spreading ischemia based on an abnormal response of the cerebral microcirculation to spreading depolarization offer an additional possible mechanism for delayed ischemia. That such events can occur in the substantial absence of proximal vasospasm is compatible with this concept, but the preliminary evidence needs support from more extensive studies.
大脑环主要分支的血管痉挛与迟发性脑缺血和蛛网膜下腔出血（aSAH）不良预后之间的关联证据一直存在不一致。基于大脑微循环对扩散去极化的异常反应，皮质扩散性缺血的实验室首次发现，以及最近在 aSAH 患者中证实，为迟发性缺血提供了另一种可能的机制。在近端血管痉挛明显不存在的情况下发生这种情况与这一概念是一致的，但初步证据需要更多广泛研究的支持。
