Hayashi M, Ishii H, Handa Y, Kobayashi H, Kawano H, Kabuto M
J Neurosurg. 1987 Jul;67(1):97-101. doi: 10.3171/jns.1987.67.1.0097.
Plateau waves reflect both dilatation of the cerebral vessels and an increase in the cerebral blood volume under increased intracranial pressure (ICP). They are often associated with changes in arterial blood pressure (BP) and respiration, suggesting a role of the brain stem in their development. In experiments conducted on dogs in which intracranial hypertension was induced by occluding the neck veins, the authors stimulated the brain-stem reticular formation in the medulla oblongata and caudal pons to identify the brain sites that produce plateau-like responses. A rise in ICP was observed following stimulation of most areas of the brain stem and was associated with changes in arterial BP, cerebral perfusion pressure (CPP), cerebral blood flow (CBF), respiration, and pulse rate. The stimuli delivered to the medial reticular formation of the caudal medulla caused an arterial depressor response, a decrease in CPP and CBF, suppressed ventilation, and bradycardia; these responses were similar in many respects to plateau waves observed in clinical practice and almost corresponded to the depressor region of the vasomotor center. It is hypothesized that the medullary depressor area may play a role in eliciting cerebral vasomotor reaction concerned with the development of plateau waves in a state of increased ICP.
高原波反映了颅内压（ICP）升高时脑血管的扩张和脑血容量的增加。它们常与动脉血压（BP）和呼吸的变化相关，提示脑干在其形成过程中发挥作用。在通过结扎颈静脉诱导颅内高压的犬类实验中，作者刺激延髓和脑桥尾端的脑干网状结构，以确定产生类似高原反应的脑区。刺激脑干的大多数区域后观察到颅内压升高，并伴有动脉血压、脑灌注压（CPP）、脑血流量（CBF）、呼吸和脉搏率的变化。刺激延髓尾端内侧网状结构会引起动脉降压反应、CPP和CBF降低、通气抑制和心动过缓；这些反应在许多方面与临床实践中观察到的高原波相似，几乎与血管运动中枢的降压区域相对应。据推测，延髓降压区可能在引发与颅内压升高状态下高原波形成相关的脑血管运动反应中起作用。
