Muhonen M G, Greene G M, Heistad D D, Loftus C M
Division of Neurosurgery, University of Iowa College of Medicine, Iowa City 52242.
Am J Physiol. 1994 May;266(5 Pt 2):H2074-81. doi: 10.1152/ajpheart.1994.266.5.H2074.
After occlusion of an artery to the brain, hypercarbia and seizures may produce a paradoxical reduction in cerebral blood flow to the region supplied by collateral vessels. We measured pressure in an occluded branch of the middle cerebral artery and measured regional cerebral blood flow (rCBF) to collateral-dependent cerebrum in dogs (n = 25) to examine hemodynamic mechanisms that account for the reduction in flow. During hypercarbia (arterial PCO2 = 70 +/- 5 mmHg), rCBF to collateral-dependent cerebrum, measured with microspheres and identified using the shadow flow technique, decreased from 95 +/- 6 (mean +/- SE) to 71 +/- 9 ml.100 g-1.min-1 (P < 0.05), while flow to normal brain increased from 105 +/- 9 to 281 +/- 15 ml.100 g-1.min-1 (P < 0.05). Pressure in a branch of the middle cerebral artery decreased during hypercarbia from 50 +/- 6 to 25 +/- 3 mmHg (P < 0.05), concurrent with a significant increase in resistance of collateral vessels. Small vessel resistance was the same in collateral-dependent and normal brain. During bicuculline-induced seizures, with blood pressure maintained at control levels by withdrawal of blood, rCBF decreased in collateral-dependent cerebrum from 128 +/- 16 to 67 +/- 11 ml.100 g-1.min-1 (P < 0.05), and flow to normal brain increased from 169 +/- 14 to 418 +/- 17 ml.100 g-1.min-1 (P < 0.05). Small vessel resistance decreased in both regions, but the decrease was much greater in normal cerebrum. Changes in cerebral artery pressure and resistance of collateral vessels during seizure were similar to those during hypercarbia.(ABSTRACT TRUNCATED AT 250 WORDS)
大脑动脉闭塞后,高碳酸血症和癫痫发作可能会使侧支血管供血区域的脑血流量出现反常减少。我们测量了犬(n = 25)大脑中动脉闭塞分支的压力,并测量了侧支依赖大脑区域的局部脑血流量(rCBF),以研究导致血流量减少的血流动力学机制。在高碳酸血症期间(动脉PCO2 = 70 ± 5 mmHg),用微球测量并用阴影血流技术识别的侧支依赖大脑区域的rCBF从95 ± 6(平均值 ± 标准误)降至71 ± 9 ml·100 g-1·min-1(P < 0.05),而正常脑区的血流量从105 ± 9增加至281 ± 15 ml·100 g-1·min-1(P < 0.05)。高碳酸血症期间大脑中动脉分支的压力从50 ± 6降至25 ± 3 mmHg(P < 0.05),同时侧支血管阻力显著增加。侧支依赖大脑区域和正常脑区的小血管阻力相同。在荷包牡丹碱诱发癫痫发作期间,通过放血将血压维持在对照水平,侧支依赖大脑区域的rCBF从128 ± 16降至67 ± 11 ml·100 g-1·min-1(P < 0.05),正常脑区的血流量从169 ± 14增加至418 ± 17 ml·100 g-1·min-1(P < 0.05)。两个区域的小血管阻力均降低,但正常脑区的降低幅度更大。癫痫发作期间大脑动脉压力和侧支血管阻力的变化与高碳酸血症期间相似。(摘要截短于250字)