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硬脑膜窦闭塞致静脉循环障碍的实验研究

Experimental study of venous circulatory disturbance by dural sinus occlusion.

作者信息

Gotoh M, Ohmoto T, Kuyama H

机构信息

Department of Neurological Surgery, Okayama University Medical School, Japan.

出版信息

Acta Neurochir (Wien). 1993;124(2-4):120-6. doi: 10.1007/BF01401133.

Abstract

Using a newly devised model of dural sinus occlusion, we investigated the pathophysiology of venous haemorrhage as well as venous circulatory disturbance. The superior sagittal sinus (SSS) and diploic veins (DV) were occluded in 16 cats. Intracranial pressure (ICP), cerebral blood volume (CBV) and regional cerebral blood flow (rCBF) were measured for 12 hours after the occlusion. At the end of the experiment, cerebral water content was estimated. In another 8 cats additional occlusions of cortical veins were carried out. In both groups, the blood-brain barrier permeability was evaluated with Evans blue or horseradish peroxidase. The SSS and DV occlusion produced a significant increase in ICP and CBV concomitant with a significant decrease in rCBF. Cerebral water content also increased significantly. However, there was no transition of Evans blue and horseradish peroxidase through the cerebral vessels, and no haemorrhages could be observed. In contrast, the additional occlusion of cortical veins produced haemorrhagic infarctions with Evans blue extravasation in 6 out of the 8 cats. These data suggest that dural sinus occlusion may lead to an increase in CBV and cerebral water content resulting in intracranial hypertension and decreased rCBF. The brain oedema in this model seemed to be mainly hydrostatic oedema, and might also be contributed by cytotoxic oedema. The additional occlusion of cortical veins might be essential in the development of haemorrhage in this model, and the blood-brain barrier was also disrupted in these areas.

摘要

我们使用一种新设计的硬脑膜窦闭塞模型,研究了静脉出血的病理生理学以及静脉循环障碍。对16只猫的上矢状窦(SSS)和板障静脉(DV)进行了闭塞。在闭塞后12小时测量颅内压(ICP)、脑血容量(CBV)和局部脑血流量(rCBF)。在实验结束时,估计脑含水量。对另外8只猫进行了皮质静脉的额外闭塞。在两组中,用伊文思蓝或辣根过氧化物酶评估血脑屏障通透性。SSS和DV闭塞导致ICP和CBV显著增加,同时rCBF显著降低。脑含水量也显著增加。然而,伊文思蓝和辣根过氧化物酶未穿过脑血管,也未观察到出血。相比之下,额外闭塞皮质静脉导致8只猫中有6只出现出血性梗死伴伊文思蓝外渗。这些数据表明,硬脑膜窦闭塞可能导致CBV和脑含水量增加,从而导致颅内高压和rCBF降低。该模型中的脑水肿似乎主要是静水压性水肿,也可能由细胞毒性水肿所致。皮质静脉的额外闭塞在该模型出血的发生中可能至关重要,并且这些区域的血脑屏障也受到了破坏。

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