Weinand M E
Department of Surgery, University of Kansas Medical Center, Kansas City 66103.
Med Hypotheses. 1988 May;26(1):51-3. doi: 10.1016/0306-9877(88)90112-0.
Vasogenic brain edema occurs as a result of a diverse spectrum of central nervous system pathology. The fundamental physiologic abnormality of vasogenic brain edema is an increase in cerebral capillary permeability. It is hypothesized that the recent development of new, potent, synthetic vasopressin antagonists will make it possible to impede the formation of vasogenic brain edema by the intraventricular administration of such agents with the subsequent inhibition of the neural control of brain capillary permeability by the locus ceruleus. The action of the vasopressin antagonists should be synergistic with the anti-edema effects of central alpha-adrenergic blockade produced by phentolamine. The combination of these two modes of therapy is expected to produce an increase in intracranial pressure which will require additional forms of medical therapy to control, in spite of the overall decrease of brain parenchymal water content.
血管源性脑水肿是由多种中枢神经系统病变引起的。血管源性脑水肿的基本生理异常是脑毛细血管通透性增加。据推测，新型强效合成血管加压素拮抗剂的最新研发成果将使得通过脑室内给予此类药物，随后抑制蓝斑对脑毛细血管通透性的神经控制，从而有可能阻止血管源性脑水肿的形成。血管加压素拮抗剂的作用应与酚妥拉明产生的中枢α-肾上腺素能阻滞的抗水肿作用协同。尽管脑实质含水量总体下降，但预计这两种治疗方式的联合应用会导致颅内压升高，这将需要额外的药物治疗形式来控制。
