Göbel H, Klostermann H, Lindner V, Schenkl S
Department of Neurology, Christian Albrechts University, Kiel, FRG.
Cephalalgia. 1990 Jun;10(3):117-22. doi: 10.1046/j.1468-2982.1990.1003117.x.
We used transcranial Doppler ultrasonography in 45 patients to investigate if changes in haemodynamics in the major arteries of the brain base occurred after lumbar puncture and whether or not patients with or without post-lumbar puncture headache differ with respect to their cerebral haemodynamic parameters before and after lumbar puncture. Before lumbar puncture, patients with post-lumbar puncture headache differed from patients without post-lumbar puncture headache in that they showed significantly higher flow velocities and significant asymmetry of flow velocities with lateralization to the right (p less than or equal to 0.05). Patients without post-lumbar puncture headache, on the other hand, showed non-significant flow velocity lateralization to the left. Forty-eight hours after lumbar puncture, both groups demonstrated symmetrical flow velocities. In addition, only patients with post-lumbar puncture headache showed a significant reduction in the flow velocity of the right middle cerebral artery (p less than or equal to 0.05). These findings suggest that it is not only absolute flow velocity that plays a part in the event of headache, the interhemispheric relation of cerebral haemodynamics also plays a fundamental role.
我们对45例患者进行经颅多普勒超声检查，以研究腰椎穿刺后颅底主要动脉的血流动力学是否发生变化，以及有或无腰穿后头痛的患者在腰穿前后的脑血流动力学参数是否存在差异。腰穿前，有腰穿后头痛的患者与无腰穿后头痛的患者不同，前者显示出明显更高的血流速度以及血流速度的显著不对称，且向右偏侧化（p≤0.05）。另一方面，无腰穿后头痛的患者血流速度向左偏侧化不显著。腰穿后48小时，两组均显示血流速度对称。此外，只有有腰穿后头痛的患者右侧大脑中动脉血流速度显著降低（p≤0.05）。这些发现表明，在头痛发生过程中，不仅绝对血流速度起作用，脑血流动力学的半球间关系也起着重要作用。
