Kuroda S, Kamiyama H, Isobe M, Houkin K, Abe H, Mitsumori K
Department of Neurosurgery, Hokkaido University School of Medicine, Sapporo, Japan.
Childs Nerv Syst. 1995 Apr;11(4):214-9. doi: 10.1007/BF00277656.
"Re-build-up" phenomenon, induced by hyperventilation, is a characteristic finding on electroencephalogram (EEG) in children with moyamoya disease, and suggests close correlation with cerebral ischemic attack. Its mechanism, however, remains obscure. In this study, we examined the relationship between the cerebral hemodynamics and this phenomenon before and after vascular reconstructive surgery. Regional cerebral blood flow and its reactivity to acetazolamide were analyzed using the xenon-133 inhalation method and single photon emission computed tomography in six children with moyamoya disease. These results were compared with the EEG. Regional vasoreactivity to acetazolamide was significantly lower in "re-build-up" -positive regions than in "re-build-up" -negative regions. Postoperative studies revealed a significant improvement of reactivity in the regions where the "re-build-up" phenomenon disappeared after surgery. These results suggest that the "re-build-up" phenomenon represents a focal reduction of the cerebral perfusion reserve in moyamoya disease.
由过度换气诱发的“再灌注”现象是烟雾病患儿脑电图（EEG）的特征性表现，提示与脑缺血发作密切相关。然而，其机制仍不清楚。在本研究中，我们检查了血管重建手术前后脑血流动力学与这种现象之间的关系。采用氙-133吸入法和单光子发射计算机断层扫描技术，分析了6例烟雾病患儿的局部脑血流量及其对乙酰唑胺的反应性。将这些结果与脑电图进行比较。“再灌注”阳性区域对乙酰唑胺的局部血管反应性明显低于“再灌注”阴性区域。术后研究显示，术后“再灌注”现象消失的区域反应性有显著改善。这些结果表明，“再灌注”现象代表烟雾病中脑灌注储备的局灶性降低。
