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[慢性脑部疾病中脑室系统的状态及脑脊液变化的动力学]

[Status of the ventricular system and dynamics of the cerebrospinal fluid changes in chronic brain diseases].

作者信息

Burtsev E M, Starodubtsev A V

出版信息

Zh Nevropatol Psikhiatr Im S S Korsakova. 1988;88(2):36-40.

PMID:3259771
Abstract

Using noninvasive (echoventriculometry (Echo-VM), REG and invasive (planimetric PEG, graphic recording of the CSF pressure) methods of examination, the authors determined the size of cerebral ventricles and the status of the cerebral hemo- and CSF dynamics in 606 patients with various chronic diseases of the brain (consequences of craniocerebral injury, epilepsy, discirculatory encephalopathy, etc.). According to PEG and Echo-VM findings, two groups of patients were distinguished. In moderate dilatation of cerebral ventricles the most significant finding was an increase in the pulse pressure of the CSF, whereas its mean pressure was normal or slightly elevated. In patients with pronounced hydrocephaly the pulse and mean pressure of the CSF tended to decrease. The progress of hydrocephaly was parallelled by increasing disorders of the cerebral hemodynamics expressed in hindered venous outflow from the cranial cavity and elevated peripheral vascular resistance. Four CSF-related syndromes have been identified (normotension, total CSF hypertension, intraventricular tension, total CSF hypotension) differing in their diagnostic and prognostic significance and in the pathogenesis of disorders of the hemo- and CSF dynamics.

摘要

作者采用无创检查方法(超声脑室测量法(Echo-VM)、脑血流图(REG))和有创检查方法(平面测量PEG、脑脊液压力图形记录),对606例患有各种慢性脑部疾病(颅脑损伤后遗症、癫痫、血液循环障碍性脑病等)的患者进行了脑室大小及脑血流和脑脊液动力学状况的测定。根据PEG和Echo-VM的检查结果,将患者分为两组。在脑室中度扩张时,最显著的发现是脑脊液脉压升高,而其平均压力正常或略有升高。在明显脑积水的患者中,脑脊液的脉压和平均压力往往降低。脑积水的进展伴随着脑血流动力学紊乱的加剧,表现为颅腔静脉流出受阻和外周血管阻力升高。已确定了四种与脑脊液相关的综合征(正常压力、脑脊液总体高压、脑室内高压、脑脊液总体低压),它们在诊断和预后意义以及血流和脑脊液动力学紊乱的发病机制方面各不相同。

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