Yamagata S, Kikuchi H, Hashimoto K
Department of Neurosurgery, Kyoto, Japan.
No Shinkei Geka. 1988 Sep;16(10):1133-9.
Several kinds of monitoring systems to evaluate cerebral function have been introduced such as somatosensory evoked potential, visual evoked potential and auditory brain stem response. Although these monitoring systems are employed in practice in neurosurgical operations, the reversibility of these cerebral functions after ischemia insult is little known. In this study the reversibility of direct cortical response (DCR) as well as EEG from global ischemia was investigated using total 60 cats. Cortical cerebral blood flow was also measured continuously by the thermal diffusion flow probe with a peltier stack calibrated by hydrogen clearance. Global ischemia was made by the occlusion of innominate and left subclavian arteries. Although the EEG was abolished soon after occlusion of these arteries, DCR was preserved and it started to decay at the cortical CBF of about 21 ml/100 g/min. It had completely disappeared at the CBF of about 8 ml/100 g/min. Recovery of DCR was not correlated with the occlusion time, but it was well correlated with the interval of loss of DCR. When the DCR was not completely lost, DCR amplitude was completely recovered about 3 hours after ischemia insult with the CBF below 20 ml/100 g/min. Moreover, in all 8 cats which were recirculated within 5 minutes after loss of DCR, complete recovery of DCR amplitude was obtained. However, it was observed in 10 of 12 cats (83%) with 10 minutes loss of DCR, 5 of 12 cats (42%) with 15 minutes loss of DCR, 4 of 14 cats (29%) with 20 minutes loss of DCR, and only one of 11 cats (10%) with 30 minutes loss of DCR.(ABSTRACT TRUNCATED AT 250 WORDS)
已经引入了几种用于评估脑功能的监测系统,如体感诱发电位、视觉诱发电位和听觉脑干反应。尽管这些监测系统在神经外科手术中得到了实际应用,但缺血损伤后这些脑功能的可逆性却鲜为人知。在本研究中,使用总共60只猫研究了全脑缺血后直接皮层反应(DCR)以及脑电图的可逆性。还使用经氢清除校准的珀耳帖堆栈热扩散流量探头连续测量皮层脑血流量。通过阻断无名动脉和左锁骨下动脉造成全脑缺血。尽管在这些动脉阻断后脑电图很快消失,但DCR得以保留,并且在皮层脑血流量约为21毫升/100克/分钟时开始衰减。在脑血流量约为8毫升/100克/分钟时它完全消失。DCR的恢复与阻断时间无关,但与DCR丧失的间隔密切相关。当DCR未完全丧失时,缺血损伤后约3小时,脑血流量低于20毫升/100克/分钟时,DCR振幅完全恢复。此外,在DCR丧失后5分钟内进行再灌注的所有8只猫中,DCR振幅完全恢复。然而,在DCR丧失10分钟的12只猫中有10只(83%)、DCR丧失15分钟的12只猫中有5只(42%)、DCR丧失20分钟的14只猫中有4只(29%)以及DCR丧失30分钟的11只猫中只有1只(10%)观察到这种情况。(摘要截断于250字)