Wallenfang T, Fries G, Jantzen J P, Bayer J, Trautmann F
Neurosurgical Clinic, University of Mainz Medical School, Federal Republic of Germany.
Acta Neurochir Suppl (Wien). 1988;43:182-5. doi: 10.1007/978-3-7091-8978-8_39.
The prognosis of intracerebral haemorrhage is extremely poor when arterial hypertension is present. We investigated elastance of the brain tissue and brain hydraulic conductivity in normotensive (MAP approximately 110 mmHg) and hypertensive (MAP approximately 170 mmHg/angiotensin infusion) cats following a stereotactically produced intracerebral haemorrhage. For 12 hours after the onset of haemorrhage we registered the course of ICP, subsequently the water content of cortex, white matter and basal ganglia as well as the interstitial concentration of serum proteins in the corresponding regions were determined (Evans-Blue, immunofluorescence). Hypertension was associated with a slight increase in ICP and tissue water content but with a 3 fold more elevated content of interstitial serum proteins. Immunofluorescence analysis showed the oedema in the hypertensive group to be vasogenic in nature and in the normotensive cats to originate from the haematoma itself. The generally poor outcome of intracerebral mass haemorrhage in hypertensive subjects could be ascribed to the nature of the concomitant brain oedema, as described in this study.
当存在动脉高血压时，脑出血的预后极差。我们研究了在立体定向制造脑出血后的正常血压（平均动脉压约110mmHg）和高血压（平均动脉压约170mmHg/输注血管紧张素）猫的脑组织弹性和脑液压传导率。在出血开始后的12小时内，我们记录了颅内压的变化过程，随后测定了皮质、白质和基底神经节的含水量以及相应区域的血清蛋白间质浓度（伊文思蓝、免疫荧光法）。高血压与颅内压和组织含水量的轻微增加有关，但间质血清蛋白含量升高了3倍。免疫荧光分析显示，高血压组的水肿本质上是血管源性的，而正常血压猫的水肿则源于血肿本身。如本研究所述，高血压患者脑实质内大量出血的总体不良预后可能归因于伴随的脑水肿的性质。
