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基底动脉构型与双侧颈总动脉结扎后交感神经上颈节缺血之间的矛盾关系。

Paradoxic Relations between Basilar Artery Reconfiguration and Superior Cervical Ganglia Ischemia After Bilateral Common Carotid Artery Ligation.

机构信息

Department of Neurosurgery, Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey.

Department of Pediatric Neurology, Kocaeli Derince Education and Research Hospital, Kocaeli, Turkey.

出版信息

World Neurosurg. 2019 May;125:e658-e664. doi: 10.1016/j.wneu.2019.01.144. Epub 2019 Feb 1.

Abstract

BACKGROUND

The relationship between superior cervical ganglia (SCG) ischemia due to bilateral common carotid artery ligation (BCCAL) and basilar artery (BA) reconfiguration was investigated.

METHODS

Twenty-three rabbits were randomly divided into 3 groups: group III rabbits underwent BCCAL (n = 13), group II rabbits were sham-operated controls (n = 5), and group I rabbits did not undergo surgery (n = 5). Degenerated neuron densities (DND) within the SCG were correlated with the BA vasodilatation index (VDI).

RESULTS

Mean live and DND in SCG of group I rabbits were 11.235 ± 982/μm and 11 ± 3/μm, respectively, with a mean heart rate of 294 ± 21 beats/min. Mean SCG DND and heart rates were 213 ± 42/μm and 242 ± 17 beats/min for the sham group (group II) rabbits and 1743 ± 285/μm and 199 ± 19 beats/min for the study group (group III) rabbits, respectively. The BA VDI values in the sham group (group II) (1.32 ± 0.10) and the study group (group III) (0.976 ± 0.112) significantly differed from those in the control group (group I) (1.65 ± 0.12; P < 0.005) versus the sham group (group II) (P < 0.0001) versus the BCCAL applied group (group III) and between group II and group III (P < 0.005).

CONCLUSIONS

A meaningful and paradoxic correlation was detected between the BA VDI values and degenerated neuron density of SCG after BCCAL. Although a low degenerated neuron density within SCG may provoke excessive sympathetic activity and prevent excessive BA dilatation with steno-occlusive carotid artery diseases, a high degenerated neuron density may cause dangerous vasodilatation of BA.

摘要

背景

研究了由于双侧颈总动脉结扎(BCCAL)引起的颈上神经节(SCG)缺血与基底动脉(BA)重构之间的关系。

方法

将 23 只兔子随机分为 3 组:BCCAL 组(n=13)、假手术对照组(n=5)和未手术组(n=5)。SCG 内变性神经元密度(DND)与 BA 血管扩张指数(VDI)相关。

结果

未手术组(I 组)兔子的 SCG 活神经元和 DND 分别为 11.235±982/μm 和 11±3/μm,平均心率为 294±21 次/分。假手术组(II 组)兔子的 SCG DND 和心率分别为 213±42/μm 和 242±17 次/分,研究组(III 组)兔子的 DND 和心率分别为 1743±285/μm 和 199±19 次/分。假手术组(II 组)(1.32±0.10)和研究组(III 组)(0.976±0.112)的 BA VDI 值与对照组(I 组)(1.65±0.12)相比差异有统计学意义(P<0.005),与假手术组(II 组)相比差异有统计学意义(P<0.0001),与 BCCAL 组(III 组)相比差异有统计学意义,与 II 组和 III 组之间差异有统计学意义(P<0.005)。

结论

BCCAL 后,BA VDI 值与 SCG 变性神经元密度之间存在有意义的矛盾关系。尽管 SCG 内低变性神经元密度可能引起过度的交感神经活动,并防止颈内动脉狭窄性疾病导致 BA 过度扩张,但高变性神经元密度可能导致 BA 危险的血管扩张。

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