小児硬膜下腔液体貯溜病態の検討 : 特に圧分析よりみて

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We attempted a pressure study of subdural fluid in 26 infant and child patients. The method used in the pressure study was as follows: a continuous recording was carried out with a polyethylene catheter inserted into the subdural fluid and connected to an externally placed pressure transducer and an amplifier chart recorder. The subdural pressure was measured by continuous recording over a period of 36 hours and then the subdural pulse waves were analyzed. The subdural mean pressures were classified into three patterns, namely A) continuous high pressure (more than 200 mm H_2O), B) intermittent high pressure, and C) continuous low pressure (less than 100 mm H_2O). Generally, both high pressure patterns were recognized in cases presenting light head injury or meningitis. Re-expansion of the brain was observed following surgical procedures in such cases. On the other hand the continuous low pressure pattern was observed in cases of brain atrophy following serious traumatic event and unknown etiology, and re-expansion of the brain was not obtained by surgical procedures. In analyzing pulse waves, polyphasic patterns were observed in cases of light traumatic event or unknown etiology. However, arch-like patterns were observed in ceases where severe atrophic change of the brain occurred after various original diseases. The intracranial cavity contains three constituents, i.e., brain tisstue, cerebrospinal fluid and blood, When the equilibrium of the three is disturbed, there is subdural collection of fluid to compensate for brain damage and changes in subdural pressure. We therefore consider measurement of subdural pressure and analysis of pulse waves to be significant in estimation of the degree of brain damage and to provide information for therapeutic indications.
日本脳神経外科学会の論文
1980-09-15

小児硬膜下腔液体貯溜病態の検討 : 特に圧分析よりみて

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