硬膜外造影術(Peridurography)に関する知見補遺,殊にその偶発症に関する研究
スポンサーリンク
概要
- 論文の詳細を見る
Accident occurring in peridurography were studied on 97 rabbits by the experiments using Urografin, electromyographic examinations, and histopathological observation. The results obtained were as follows :<BR>(1) In peridurography, spinal puncture should be avoided as much as possible. If a cerebrospinal-fluid examination has to precede unavoidably, the peridurography should not be performed until a considerable number of days, or at least 2 weeks have passed following the test.<BR>(2) If any accident occurs unfortunately, it is primarily imperative that the air-passages are first secured, and then spinal or suboccipital puncture performed in order to wash off or eliminate the agent that had leaked into the cerebrospinal fluid.<BR>(3) In view of the intradural injections, as suggested from the results of the experiment on rabbits, a dosage of 0.2 c. c. of contrast medium per kilogram of body weight would be safe and enough to attain the purpose of peridurography.<BR>(4) On the obtained electromyograms, cramps were seen to occur concurrently over the whole body, and the wave patterns were of grouping voltage. This was attributable to the disturbances of the central nerves, coinciding with the pathological findings and the clinical symptoms.<BR>(5) In the surviving rabbit group, hydropic changes and congestion in the meninx became a little severer with the course of time, and atrophy of nerve cells tended to appear correspondingly.<BR>(6) Histolopathologically, acute swelling was recognized in the death group in the Ammon's horn, the gray substance of the telencephalon, and the nerve nuclei of the diencephalon, mainly occurring in the nerve cells of those, areas. Besides, vascular degeneration was sporadically observed.<BR>(7) In the case with severe pathological changes, every cerebral area strongly showed porosis, dilation of the Virchow-Robin space, and hydrops in the subepithelial layer of the cerebral ventricles, all based on the hydropic changec that were seen generally in the cerebral tissues.<BR>(8) In the medulla oblongata and the spinal cord, degenerative changes of circulatory disturbances were marked and became slightly more intensive in the lower portions of the spinal cord.<BR>(9) The pathological changes of the central nervous system occurring in the death group of the present experiment might resemble to the tissue experession due to cramps.<BR>(10) Urografin has been employes as an angiographic medium and results were satisfactory. It has no disturbance to the central nerves and other organs when injected into the blood vessels, and therefore it does not cause so severe disturbances in the blood-brain barrier and the blood-liquor barrier. On the contrary, if injected into the cerebrospinal fluid, this agent produces drastic sympotoms or causes death. If seems that the agent may destroy the liquor-brain barrier and penetrate easily into the central nervous tissue giving rise to a marked disturbance of the central nervous tissue, which would be an important factor in causing death.
- 学校法人 昭和大学・昭和医学会の論文