Fitch W, McDowall D G, Keaney N P, Pickerodt V W
J Neurol Neurosurg Psychiatry. 1977 Sep;40(9):843-52. doi: 10.1136/jnnp.40.9.843.
Continued expansion of an artificial space-occupying lesion produced further increases in mean supratentorial and infratentorial pressures associated with increases in mean arterial pressure, heart rate, and systemic vascular resistance-the `Cushing' or systemic hypertensive response. These primary changes resulted in an increase in transtentorial pressure gradient and a decrease in arrhythmia index. Immediately before the onset of the systemic hypertensive response, supratentorial perfusion pressure was low, and the period of systemic hypertension did not appear to produce any worthwhile improvement in the perfusion pressure or in the blood flow in the supratentorial compartment. The studies demonstrated also that the systemic hypertensive response was a pre-terminal event and was followed rapidly by circulatory failure.
人工占位性病变的持续扩大导致幕上和幕下平均压力进一步升高,同时伴有平均动脉压、心率和全身血管阻力增加,即“库欣”反应或全身性高血压反应。这些原发性变化导致经天幕压力梯度增加,心律失常指数降低。在全身性高血压反应即将开始之前,幕上灌注压较低,全身性高血压期似乎并未使幕上腔室的灌注压或血流量得到任何有价值的改善。研究还表明,全身性高血压反应是终末期前的事件,随后很快就会出现循环衰竭。