George B, Levante A, Visot A, Cophignon J
Neurochirurgie. 1977 Mar 15;23(1):37-46.
A correlative study is done between observation of cases of shunted hydrocephalus with mesencephalic signs such as Parinaud's syndrome and a multiunitary recording of mesencephalic and bulbar reticular formation activities during acute and chronic intracranial hypertension in cats. Clinical and experimental data are first separately analysed and then superimposed. This results in analysing the evolution of such intracranial hypertension in three stages: first stage of "tolerance" with minimal clinical signs and no change of reticular activity; second stage of "uncompensation" when mesencephalic signs appear and with increased mesencephalic activity and unchanged bulbar activity; third stage of "exhaustion" where can be noted disorders of consciousness, decerebration fits, and cardiorespiratory disorders; mesencephalic activity falls down to lower levels than basal ones, bulbar activity increases first and then also decreases rapidly. This suggests a mechanism of exhausting stocks of monoamines but also of change of the local cerebral blood flow. Increase and then fall of the reticular activity may be the general way, even without any herniation, of evolution of any intracranial hypertension of traumatic or tumoral origin.
对伴有中脑体征(如帕里诺德综合征)的分流性脑积水病例进行观察,并对猫在急性和慢性颅内高压期间中脑和延髓网状结构活动进行多单位记录,二者之间开展了一项相关性研究。临床和实验数据首先分别进行分析,然后叠加在一起。这使得颅内高压的演变可以分为三个阶段进行分析:第一阶段为“耐受期”,临床体征轻微,网状活动无变化;第二阶段为“失代偿期”,此时出现中脑体征,中脑活动增加,延髓活动无变化;第三阶段为“衰竭期”,可观察到意识障碍、去大脑强直发作和心肺功能障碍;中脑活动降至低于基础水平,延髓活动先增加,然后也迅速下降。这提示了单胺储备耗竭以及局部脑血流变化的机制。网状活动的先增加后下降可能是任何创伤性或肿瘤性颅内高压演变的一般方式,即使没有任何脑疝形成。