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实验性动脉蛛网膜下腔出血对脑循环的早期影响。第二部分:实验性蛛网膜下腔出血后的局部脑血流和脑微循环

Early effects of experimental arterial subarachnoid haemorrhage on the cerebral circulation. Part II: Regional cerebral blood flow and cerebral microcirculation after experimental subarachnoid haemorrhage.

作者信息

Trojanowski T

出版信息

Acta Neurochir (Wien). 1984;72(3-4):241-55. doi: 10.1007/BF01406874.

Abstract

Employing the experimental set-up and the methods described - in part I of the paper, the measurements of the regional cerebral blood flow (rCBF) and evaluation of brain microcirculation were performed. The control series provided normal values and constituted the reference for the results of the post-haemorrhagic measurements. Arterial subarachnoid haemorrhage increases transitorily the intracranial pressure to values close to the diastolic blood pressure. The rise of the blood pressure (Cushing response) is not adequate to prevent the reduction in the cerebral perfusion pressure. Cerebral blood flow diminishes after arterial subarachnoid haemorrhage during the elevation of intracranial pressure. It results in numerous, disseminated areas of reduced regional cerebral blood flow. During 4 hours following arterial subarachnoid haemorrhage global cerebral blood flow returns to normal values, while focal reductions in blood flow persist in the grey matter structures of both hemispheres. These foci are accompanied by confined areas of markedly increased regional cerebral blood flow. Disseminated foci with a reduced number of patent capillaries are found in the grey matter structures of both hemispheres 1 and 4 hours following arterial subarachnoid haemorrhage. Their number decreases during the 4 hours observation.

摘要

采用本文第一部分所述的实验装置和方法,进行了局部脑血流量(rCBF)的测量和脑微循环的评估。对照组提供了正常值,并作为出血后测量结果的参考。动脉性蛛网膜下腔出血会使颅内压短暂升高至接近舒张压的值。血压升高(库欣反应)不足以防止脑灌注压降低。在颅内压升高期间,动脉性蛛网膜下腔出血后脑血流量会减少。这会导致出现大量散在的局部脑血流量减少区域。在动脉性蛛网膜下腔出血后的4小时内,全脑血流量恢复到正常值,而两个半球灰质结构中的局部血流减少仍持续存在。这些病灶伴有局部脑血流量明显增加的区域。在动脉性蛛网膜下腔出血后1小时和4小时,在两个半球的灰质结构中发现了散在的毛细血管开放数量减少的病灶。在4小时的观察期间,它们的数量减少。

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