正常圧水頭症髄液中紫外部吸光物質の検索
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概要
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Optical densities (OD) were measured in ultraviolet absorption ranging from 210 to 310 nm in cerebrospinal fluid (CSF) samples obtained from 33 cases of adult normal pressure hydrocephalus. CSF samples from 100 patients, who had no neurological disorders served as control. All cases of adult normal pressure hydrocephalus were divided into three groups (excellent, good, non effec-tive) according to the clinical improvement following the ventriculo-peritoneal (V-P) shunt opera-tion. Two absorption peaks were ordinarily found in spectrophotometric analysis in CSF. The first peak at 230 nm was identified as the complex of albumin, y-globulin and a few peptides through various biochemical analyses. The OD at 230 nm were significantly higher in both the excellent and good groups than in the normal control group (P<0.02,P<0.05). For 24 hours prior to the shunt operation, continuous CSF drainage was made through lumbar route and the samples taken after 24 hours showed marked increases in the OD at 230 nm in the excellent and the good recovery groups. The second peak at 267 nm known as ascorbic acid absorption, remained significantly lower in all three groups than in the control group (P<0.001). Meglumine iothalamate (MI) was found in CSF as the maximum absorption at 245 nm following intravenous administration. Twenty-two samples taken 24 hours after intravenous administration of 100 ml of MI were studied. The OD at 245 nm were significantly higher in the excellent recovery group than the one in the non effective group (P<0.01). The increases in OD at 230 and 245 nm were thought to be due to the impair-ment of either the blood-brain or blood-CSF barrier and the development of edema in brain paren-chyme. The cases who had high OD at 230 nm responded well to the V-P shunt operation. This was probably due to the removal of edema fluid through the hydrostatic pressure gradient between the brain and the ventricle. These results may be useful in deciding on surgical indication on patients of normal pressure hydrocephalus.
- 日本脳神経外科学会の論文
- 1984-12-15