McComb J G, Withers G J, Davis R L
Neurosurgery. 1981 Jan;8(1):68-71. doi: 10.1227/00006123-198101000-00013.
An experimental and clinical study was undertaken to determine whether Zenker's solution without glacial acetic acid (modified Zenker's solution) applied to the external surface of the dura mater can penetrate to injure the underlying cortex. Adult cats and dogs, the dura of which had an average thickness of 0.2 and 0.25 mm, respectively, were given intravenous Evans blue dye as an indicator of blood-brain barrier breakdown. This was followed by the application of modified Zenker's solution to the dura in a manner identical to the clinical practice. When the animals were killed 1 or 2 hours later, the cortex beneath the dura painted with modified Zenker's solution was stained massively. The thickness of human dura was measured; it varied from 0.22 to 0.28 mm in infants of 3 months or less, 0.27 to 0.42mm in infants 4 months to 12 months of age, and 0.32 to 0.45 mm in children to 1 to 18 years of age. Modified Zenker's solution applied to fresh dura for 3 minutes at autopsy gave visual evidence 1 hour later of penetration to the cortex beneath. In operative procedures for craniosynostosis, 69 patients were treated with modified Zenker's solution; of these, 7 developed seizures in the immediate postoperative period. No seizures occurred among the 39 patients on whom modified Zenker's solution was not used. It is concluded that modified Zenker's solution applied to the dura can damage the cortex beneath.
进行了一项实验和临床研究，以确定不含冰醋酸的岑克尔溶液（改良岑克尔溶液）应用于硬脑膜外表面时是否会渗透并损伤下方的皮质。分别给成年猫和狗静脉注射伊文思蓝染料，作为血脑屏障破坏的指标，这些猫和狗的硬脑膜平均厚度分别为0.2毫米和0.25毫米。随后，以与临床实践相同的方式将改良岑克尔溶液应用于硬脑膜。1或2小时后处死动物时，涂有改良岑克尔溶液的硬脑膜下方的皮质出现大量染色。测量了人类硬脑膜的厚度；3个月及以下婴儿的硬脑膜厚度在0.22至0.28毫米之间，4个月至12个月大婴儿的硬脑膜厚度在0.27至0.42毫米之间，1至18岁儿童的硬脑膜厚度在0.32至0.45毫米之间。在尸检时将改良岑克尔溶液应用于新鲜硬脑膜3分钟，1小时后可见其渗透到下方皮质的迹象。在颅缝早闭的手术过程中，69例患者接受了改良岑克尔溶液治疗；其中7例在术后即刻出现癫痫发作。未使用改良岑克尔溶液的39例患者中未发生癫痫发作。得出的结论是，应用于硬脑膜的改良岑克尔溶液会损伤下方的皮质。
