Kimura M, Suzuki S, Iwabuchi T
Department of Neurosurgery, Hirosaki University School of Medicine, Japan.
No Shinkei Geka. 1989 Jun;17(6):525-31.
The possible role of subarachnoid periarterial acidosis and platelets aggregation in symptomatic cerebral vasospasm after subarachnoid hemorrhage was studied in animal experiments. Canine or feline subarachnoid space was irrigated with low pH (6.49 +/- 0.06, N = 10) physiological saline or with high pH (8.0) Hartmann solutions after subarachnoid hemorrhage was induced by cisternal autologous blood injection. Angiographical changes of the basilar artery, neurological conditions, platelet functions in blood taken from the superior sagittal sinus, and histological findings particularly those concerning intraarterial blood were examined comparatively before and after the irrigation and, in relation to different irrigation fluids. No significant differences were observed in the angiographical changes of the basilar artery either before or after irrigation. Neither did different irrigation fluids have an effect on these changes. As for the neurological conditions, however, deterioration after irrigation was more frequent and evident in the group treated with physiological saline than in the group treated with Hartmann solution. Platelet function in the blood taken from the superior sagittal sinus also tended to be more activated in the group treated with physiological saline. In animals treated with physiological saline, histopathological examination of the autopsied brain revealed marked intraluminal platelets aggregation, particularly in the basilar artery and its branches where subarachnoid clots were mostly evident. An affirmative result for the preamble was obtained in this study.
在动物实验中研究了蛛网膜下腔动脉周围酸中毒和血小板聚集在蛛网膜下腔出血后症状性脑血管痉挛中可能发挥的作用。通过枕大池自体血注射诱导蛛网膜下腔出血后,用低pH值(6.49±0.06,N = 10)的生理盐水或高pH值(8.0)的哈特曼溶液冲洗犬或猫的蛛网膜下腔。比较冲洗前后基底动脉的血管造影变化、神经状况、从上矢状窦采集的血液中的血小板功能以及组织学发现,特别是与不同冲洗液相关的动脉内血液的组织学发现。冲洗前后基底动脉的血管造影变化均未观察到显著差异。不同的冲洗液对这些变化也没有影响。然而,就神经状况而言,生理盐水治疗组冲洗后的恶化比哈特曼溶液治疗组更频繁、更明显。从上矢状窦采集的血液中的血小板功能在生理盐水治疗组中也倾向于更活跃。在用生理盐水治疗的动物中,尸检脑的组织病理学检查显示管腔内有明显的血小板聚集,特别是在基底动脉及其分支处,蛛网膜下腔血凝块最为明显。本研究对前文所述内容得出了肯定性结果。