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三叉神经节缺血对颞动脉直径影响头皮存活的预测作用:首次实验研究。

Predictive role of trigeminal ganglion ischemia on scalp survival affected by temporal artery diameters: The first experimental study.

机构信息

Department of Plastic, Reconstructive and Aesthetic Surgery, Medical Faculty of Ataturk University, Erzurum, Turkey.

Department of Neurosurgery, Ok Meydani Education and Research Hospital, Istanbul, Turkey.

出版信息

J Plast Reconstr Aesthet Surg. 2022 Jul;75(7):2441-2450. doi: 10.1016/j.bjps.2022.02.029. Epub 2022 Feb 26.

Abstract

Scalp arteries are mainly innervated by trigeminal, facial, and vagal nerves. The ischemic neurodegeneration of the trigeminal ganglion can impede scalp circulation via vasospasm-creating effects. This study was designed to investigate whether there is any link between the vasospasm index of deep temporal arteries and ischemic neuron densities of the trigeminal ganglion after subarachnoid hemorrhage. The study subjects included five normal control rabbits, six sham rabbits, and nine rabbits chosen from a formerly established experimental subarachnoid hemorrhage group created by cisternal homologous blood injection (0.75 mL). These rabbits, all male, were followed up for 3 weeks. The trigeminal ganglion and deep temporal artery vasospasm indexes were examined by stereological methods. Ischemic neuron densities of the trigeminal ganglion and vasospasm index values of deep temporal arteries were compared statistically. Postmortem examinations showed important vasospasms of deep temporal arteries, foramen magnum herniations, and neurodegeneration of the trigeminal ganglion. The mean vasospasm index values and degenerated neuron densities of the trigeminal ganglion were determined as 1.03 ± 0.13 and 10 ± 3/mm (p > 0.5) in the control group, 1.21 ± 0.18 and 35 ± 9/mm in the sham group (p < 0.005 for sham vs. control), and 2.54 ± 0.84 and 698 ± 134/mm in the experimental group (p < 0.0005 for sham vs. control and p < 0.00001 for study vs. control). There was an inverse relationship between the vasospasm index values and the degenerated neuronal density of the trigeminal ganglion. The high degenerated neuron density in the trigeminal ganglion had a facilitative effect on temporal artery vasospasm. Trigeminal ganglion neurodegeneration may promote temporal artery vasospasms after subarachnoid hemorrhage, which has not been previously mentioned in the literature.

摘要

头皮动脉主要由三叉神经、面神经和迷走神经支配。三叉神经节的缺血性神经退行性变可通过血管痉挛作用阻碍头皮循环。本研究旨在探讨蛛网膜下腔出血后,颞深动脉的血管痉挛指数与三叉神经节的缺血性神经元密度之间是否存在关联。研究对象包括 5 只正常对照兔、6 只假手术兔和 9 只来自先前建立的通过脑池同源血液注射(0.75ml)的实验性蛛网膜下腔出血组的实验兔。这些雄性兔子均随访 3 周。采用体视学方法检查三叉神经节和颞深动脉血管痉挛指数。对三叉神经节缺血性神经元密度和颞深动脉血管痉挛指数值进行统计学比较。尸检显示颞深动脉、枕骨大孔疝和三叉神经节神经退行性变存在重要的血管痉挛。对照组、假手术组和实验组的平均血管痉挛指数值和三叉神经节变性神经元密度分别为 1.03±0.13 和 10±3/mm(对照组 p>0.5)、1.21±0.18 和 35±9/mm(假手术组 p<0.005 与对照组相比)和 2.54±0.84 和 698±134/mm(实验组 p<0.0005 与假手术组相比,p<0.00001 与对照组相比)。血管痉挛指数值与三叉神经节变性神经元密度呈负相关。三叉神经节中高变性神经元密度对颞动脉血管痉挛有促进作用。三叉神经节神经退行性变可能促进蛛网膜下腔出血后颞动脉血管痉挛,这在文献中尚未提及。

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