Sutton L N, Cho B K, Jaggi J, Joseph P M, Bruce D A
Neurosurgery. 1986 Jun;18(6):756-61. doi: 10.1227/00006123-198606000-00013.
Recent studies in human and animal subjects have suggested a relationship between intracranial pressure (ICP) and ventricular dilatation and multimodality evoked responses which, if substantiated, would be of value to clinical practice as a noninvasive way of assessing the need for shunting in selected patients in whom computed tomography (CT) is not definitive. In an attempt to better define these changes, auditory evoked response (BAER) and somatosensory evoked response (SER) were performed on 16 cats as a base line, after which they were made hydrocephalic by the cisternal injection of kaolin. Nine cats survived, and CT or magnetic resonance scans were performed on them 4 to 6 weeks later. In those animals in which ventricular dilatation was noted, repeat evoked responses were recorded. In the 6 hydrocephalic cats, the ventricle was punctured to measure ICP, which in all cases was less then 5 mm Hg. The lumbar spinal dural sac was then ligated, which resulted in periodic plateau waves up to 75 to 100 mm Hg after 4 to 6 hours, lasting up to 10 minutes. In neither group of cats was any change in either BAER or SER observed until preterminally, when ICP was in the range of 75 to 100 mm HG and cerebral perfusion pressure was compromised. This suggests that the BAER and SER are not sensitive to either ventricular dilatation or intracranial hypertension.
近期针对人类和动物受试者的研究表明，颅内压（ICP）与脑室扩张及多模态诱发反应之间存在关联。如果这一关联得到证实，那么作为一种非侵入性方法，对于计算机断层扫描（CT）检查结果不明确的特定患者，评估其是否需要分流，这将对临床实践具有重要价值。为了更好地界定这些变化，对16只猫进行了听性诱发反应（BAER）和体感诱发电位（SER）检测作为基线，之后通过向脑池注射高岭土使其发生脑积水。9只猫存活下来，4至6周后对它们进行了CT或磁共振扫描。在那些发现有脑室扩张的动物中，记录重复的诱发反应。在6只脑积水猫中，穿刺脑室测量颅内压，所有病例的颅内压均低于5毫米汞柱。然后结扎腰段硬脊膜囊，4至6小时后导致周期性的高原波，高达75至100毫米汞柱，持续长达10分钟。在两组猫中，直到濒死期颅内压处于75至100毫米汞柱且脑灌注压受到损害之前，BAER或SER均未观察到任何变化。这表明BAER和SER对脑室扩张或颅内高压均不敏感。
