Chiou T L, Chiang Y H, Song W S, Lin S S
Division of Neurosurgery, Tri-Service General Hospital, Taipei, Republic of China.
Acta Neurochir Suppl (Wien). 1994;60:459-61. doi: 10.1007/978-3-7091-9334-1_126.
Recent experimental results indicate that cerebral glia lining and glia limitans may be barriers for plasma protein extravasated from injured cerebral microvessels flowing into the adjacent subarachnoid space. Therefore, it has been hypothesized that a transdural cortical stabbing which opens both the pia lining and glia limitans may facilitate drainage of edema fluid into the subarachnoid space and minimize brain edema. This hypothesis was tested in Sprague-Dawley rats with a transdural cold-injury on the right parietal cortex. The animals were sacrificed 24 hours later. One hour before being sacrificed 0.6 ml of 2% Evans blue was intravenously injected to determining the Evans blue distribution area. For measuring the inulin retention volume in the brain, 14C-inulin (10 microCi) in 1 ml of saline was injected intravenously at 10 min before sacrifice. The extent of brain edema was assessed by measuring the water content, the inulin retention volume, and the distribution area of Evans blue in the brain. Our results showed that the transdural cortical stabbing did not alter the water content of the cerebral hemisphere with cold lesion. However, it did effectively diminish the inulin retention volume by 26% as well as the distribution area of Evans blue by 22% in the cerebral hemisphere with cold lesion. In conclusion, a transdural cortical stabbing on the injured cortex may be beneficial for vasogenic brain edema.
最近的实验结果表明，脑胶质界膜和胶质界板可能是血浆蛋白从受损脑微血管渗出后流入相邻蛛网膜下腔的屏障。因此，有人提出，经硬脑膜皮层穿刺打开软脑膜界膜和胶质界板，可能有助于水肿液排入蛛网膜下腔，并使脑水肿降至最低。在Sprague-Dawley大鼠的右侧顶叶皮层进行经硬脑膜冷损伤，对这一假说进行了验证。24小时后处死动物。处死前1小时静脉注射0.6 ml 2%伊文思蓝，以确定伊文思蓝分布区域。为测定脑中菊粉潴留量，处死前10分钟静脉注射1 ml盐水中含14C-菊粉（10微居里）。通过测量脑含水量、菊粉潴留量和脑中伊文思蓝分布区域来评估脑水肿程度。我们的结果显示，经硬脑膜皮层穿刺并未改变冷损伤侧脑半球的含水量。然而，它确实有效地使冷损伤侧脑半球的菊粉潴留量减少了26%，伊文思蓝分布区域减少了22%。总之，对受损皮层进行经硬脑膜皮层穿刺可能对血管源性脑水肿有益。
