脳血管透過性に対する高血圧および外減圧術の影響
スポンサーリンク
概要
- 論文の詳細を見る
The role of hydrostatic factors, such as acute hypertension and decompressive craniectomy, which contribute to the permeability of cerebral vessels and to brain edema were evaluated. Adult mongrel cats were subjected to induced hypertension by means of inflation of a balloon catheter placed in the descending aorta immediately distal to the left sub-clavian artery. Craniectomy of 2 x 1.5 cm was done on the right front-parietal area. The animals were divided into four groups: 1) intact control group; 2) arterial hypertension group; 3) craniectomy group; 4) combined hypertension and craniectomy group. Evans blue and horseradish peroxidase were used as tracers to quantify the extent of damage to the blood-brain barrier. The water content of the regional cerebral tissues was determined by the dry-weight method. Induced hypertension produced multifocal cortical lesions staind by Evans blue. Craniectomy also resulted in similar multifocal cortical edema in both hemispheres, though more marked on the side of the craniectomy. These lesions were mainly located at the arterial boundary zones of major cerebral arteries and leakage of tracers ceased within 24 hours. No changes were observed in either brain water content or morphological findings 48 hours after insult. When a cat was subjected to both hypertension and craniectomy, these changes became markedly intensified and Evans blue, migrated further into the adjacent white matter. When the brain was examined 48 hours later, rather extensive hemispheric edema with midline structure shift was noted. The results suggested that edema of this type is sufficiently specific in its developmental pattern and is initiated by the hydrostatic pressure gradients between blood and tissue, and between areas with different tissue pressures.
- 日本脳神経外科学会の論文
- 1983-05-15