Hornig C R, Busse O, Buettner T, Dorndorf W, Agnoli A, Akengin Z
Stroke. 1985 Mar-Apr;16(2):268-73. doi: 10.1161/01.str.16.2.268.
CT contrast enhancement of the ischemic infarction, blood-CSF barrier function for albumin, and severity of neurological symptoms were evaluated at predefined intervals in 41 patients with supratentorial ischemic infarctions. Contrast enhancement was most frequently observed in the 2nd and 3rd week after the stroke. This late CT enhancement was not related to infarction size and severity of blood-CSF barrier disturbance. The rare appearance of CT enhancement in the 1st week was usually associated with extensive infarctions and accompanied by blood-CSF barrier disturbances. These barrier disturbances, which occurred with higher frequency and greater severity in extensive infarctions (peak 3rd day), generally persisted for several weeks. We suggest that contrast enhancement in the 1st week after an ischemic stroke is due to diapedesis from necrotic capillaries; the more frequently observed late enhancement might be the result of a blood-brain barrier disturbance which in turn is hypothetically attributed to increased pinocytotic activity of regenerated endothelial cells.
在41例幕上缺血性梗死患者中，按照预定的时间间隔评估缺血性梗死的CT对比增强、白蛋白的血脑屏障功能以及神经症状的严重程度。对比增强最常出现在卒中后的第2周和第3周。这种晚期CT增强与梗死大小和血脑屏障紊乱的严重程度无关。第1周CT增强少见，通常与大面积梗死相关，并伴有血脑屏障紊乱。这些屏障紊乱在大面积梗死中出现的频率更高、程度更严重（第3天达到峰值），一般持续数周。我们认为，缺血性卒中后第1周的对比增强是由于坏死毛细血管的渗血所致；而更常见的晚期增强可能是血脑屏障紊乱的结果，反过来推测这归因于再生内皮细胞吞饮活性增加。
