da Silva M C, Michowicz S, Drake J M, Chumas P D, Tuor U I
Division of Neurosurgery, Hospital for Sick Children, University of Toronto, Canada.
J Cereb Blood Flow Metab. 1995 Nov;15(6):1057-65. doi: 10.1038/jcbfm.1995.132.
The extent to which the reduction in CBF occurring in hydrocephalus is a primary or secondary event in the pathogenesis of the brain injury that ensues has not been clearly established. This is particularly true in neonatal hydrocephalus, where the disorder is most common, and where timing of the treatment of the developing nervous system is so important. We investigated the changes in local CBF (lCBF) in an animal model of severe progressive neonatal hydrocephalus before and after CSF shunting. Hydrocephalus was induced in 27 1-week-old kittens by percutaneous injection of 0.05 ml of 25% kaolin into the cisterna magna. Fourteen littermates acted as controls. The lCBF was measured by 14C-iodoantipyrine quantitative autoradiography after 1 week in 15 animals (8 hydrocephalic, 7 controls) and after 3 weeks in 26 animals (19 hydrocephalic, 7 controls) following induction of hydrocephalus. Twelve of the 3-week hydrocephalic group received a ventriculoperitoneal shunt 10 days following kaolin injection. At 1 week following induction of hydrocephalus, lCBF was globally reduced in cortical gray matter and white matter as well as deep subcortical structures. The maximum reduction was in the parietal white matter, to 37% of control levels. At 3 weeks a significant reduction in lCBF persisted only in the white matter (parietal, occipital, and corpus callosum; average, 42% of control levels), whereas cortical gray and deep subcortical structures had returned to normal levels spontaneously.(ABSTRACT TRUNCATED AT 250 WORDS)
脑积水时发生的脑血流量(CBF)减少在随后发生的脑损伤发病机制中是原发性还是继发性事件,目前尚未明确。在新生儿脑积水中尤其如此,因为这种疾病最为常见,而且发育中的神经系统治疗时机非常重要。我们研究了严重进行性新生儿脑积水动物模型在脑脊液分流前后局部脑血流量(lCBF)的变化。通过经皮向枕大池注射0.05 ml 25%高岭土,在27只1周龄小猫中诱发脑积水。14只同窝小猫作为对照。在诱发脑积水后1周,对15只动物(8只脑积水动物,7只对照动物)进行14C-碘安替比林定量放射自显影测量lCBF;在诱发脑积水后3周,对26只动物(19只脑积水动物,7只对照动物)进行测量。3周龄脑积水组的12只动物在高岭土注射10天后接受了脑室腹腔分流术。在诱发脑积水后1周,皮质灰质、白质以及皮质下深部结构的lCBF整体降低。最大降幅出现在顶叶白质,降至对照水平的37%。在3周时,lCBF仅在白质(顶叶、枕叶和胼胝体;平均为对照水平的42%)持续显著降低,而皮质灰质和皮质下深部结构已自发恢复到正常水平。(摘要截断于250字)