DeVolder A G, Goffinet A M, Bol A, Michel C, de Barsy T, Laterre C
Positron Tomography Laboratory, University of Louvain, Belgium.
Arch Neurol. 1990 Feb;47(2):197-204. doi: 10.1001/archneur.1990.00530020103022.
Thirteen positron emission tomographic studies of cerebral glucose utilization were carried out in 12 patients with postanoxic syndrome due to cardiac arrest. Seven subjects were in a persistent vegetative state. The 5 other subjects were normally conscious, but disclosed focal neurological signs. When compared with normal values, mean cerebral glucose metabolism was drastically decreased (+/- 50%) in vegetative subjects, and to a lesser degree (+/- 25%) in conscious patients. The most consistent regional alterations were found in the parieto-occipital cortex (9 cases), the frontier between vertebral and carotid arterial territories, followed by the frontomesial junction (5 cases), the striatum (3 cases with dystonia), thalamus (2 cases), and visual cortex (2 cases with cortical blindness). These data suggest that brain anoxia can result in global brain hypometabolism, which appears related to the vigilance state, as well as in regional alterations preferentially located in arterial border zones.
对12例心脏骤停所致缺氧后综合征患者进行了13次大脑葡萄糖利用的正电子发射断层扫描研究。7名受试者处于持续性植物状态。另外5名受试者意识正常，但有局灶性神经体征。与正常值相比，植物状态受试者的平均大脑葡萄糖代谢显著降低（±50%），而意识清醒患者的降低程度较小（±25%）。最一致的区域改变见于顶枕叶皮质（9例）、椎动脉和颈动脉供血区之间的边界，其次是额中交界区（5例）、纹状体（3例伴有肌张力障碍）、丘脑（2例）和视觉皮质（2例伴有皮质盲）。这些数据表明，脑缺氧可导致全脑代谢减退，这似乎与警觉状态有关，还可导致区域改变，这些改变优先位于动脉边缘区。
