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脑血管对颅内高压的反应。

Cerebrovascular response to intracranial hypertension.

作者信息

Auer L M, Ishiyama N, Pucher R

出版信息

Acta Neurochir (Wien). 1987;84(3-4):124-8. doi: 10.1007/BF01418837.

DOI:10.1007/BF01418837
PMID:3577856
Abstract

Pial arterial and venous calibre changes during intracranial hypertension were studied in 11 cats under barbiturate- and nitrous oxide-anaesthesia by using a closed cranial window technique and multichannel videoangiometry. Intracranial pressure was elevated from a normal mean level of 6.4 mm Hg by cisternal infusion of mock CSF in steps to 20, 30, 40, 50 mm Hg and finally to the level of systolic pressure. Pial arteries dilated significantly, small ones more than large ones, by 42 +/- 5.6% and 33 +/- 3%, respectively at ICP 50. With a further elevation of ICP up to systolic pressure, dilatation diminished to 28 +/- 10% in small, and to near resting calibres in large arteries. Pial veins remained unreactive on the average. Grouping into veins smaller and larger than 100 microns of resting size revealed, however, minor though statistically significant 5-10% dilatation of small, and a 5-10% diminution of large veins. Blood flow stopped, when cerebral perfusion pressure was zero, however, neither arteries nor veins collapsed. The present data support the hypothesis that CBF during acute elevation of CSF pressure depends on perfusion pressure rather than local vascular compression.

摘要

在巴比妥酸盐和一氧化二氮麻醉下,对11只猫采用闭合式颅窗技术和多通道视频血管造影术,研究颅内高压时软脑膜动脉和静脉管径的变化。通过向脑池内注入模拟脑脊液,将颅内压从正常平均水平6.4毫米汞柱逐步升高至20、30、40、50毫米汞柱,最后升至收缩压水平。软脑膜动脉显著扩张,小动脉比大动脉扩张更明显,在颅内压为50时,小动脉和大动脉分别扩张42±5.6%和33±3%。随着颅内压进一步升高至收缩压水平,小动脉扩张幅度减小至28±10%,大动脉接近静息管径。软脑膜静脉平均无反应。然而,将静息管径小于和大于100微米的静脉分组后发现,小静脉有轻微但具有统计学意义的5 - 10%的扩张,大静脉有5 - 10%的缩小。当脑灌注压为零时血流停止,但动脉和静脉均未塌陷。目前的数据支持这样的假说,即脑脊液压力急性升高时的脑血流量取决于灌注压而非局部血管受压情况。

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