FOCAL CEREBRAL HYPEREMIA IN ACUTE STROKE - INCIDENCE, PATHO-PHYSIOLOGY AND CLINICAL-SIGNIFICANCE
FOCAL CEREBRAL HYPEREMIA IN ACUTE STROKE - INCIDENCE, PATHO-PHYSIOLOGY AND CLINICAL-SIGNIFICANCE
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DOI：
10.1161/01.str.12.5.598
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发表时间：
1981-01-01
期刊：
影响因子：
8.3
通讯作者：
LASSEN, NA
中科院分区：
文献类型：
--
作者：
OLSEN, TS;LARSEN, B;LASSEN, NA
对41例病程<72 h的完全性卒中患者在入院后24 h内进行脑血管造影和局部脑血流量(RCBF)测定。采用~(133)Xe颈动脉注射方法和254多探测器摄像机进行rCBF研究。在rCBF研究后24小时行CT扫描。局灶性脑充血16例。这项研究揭示了三种不同类型的充血。血管造影术上动脉闭塞的患者可见周围缺血区的交界区充血，推测是由于急性脑梗塞交界区酸性代谢物积聚所致。缺血后充血见于未闭塞的患者，可能是由于先前闭塞的动脉再通所致。在远离梗死区的地方发现了远端充血，推测是由于局部组织压迫脑组织所致。皮质梗塞(10例)均有广泛的充血区。由于254探测器摄像头在皮质表面具有极好的分辨率，显然所有的急性脑梗塞实际上都与充血区域有关。充血区域通常是广泛的，血管反应性通常受损。旨在减少充血区域血流的治疗可能会改善预后。
In a consecutive study comprising 41 patients with completed stroke of less than 72 h duration, cerebral angiography and measurement of the regional cerebral blood flow (rCBF) were performed within 24 h after admission. The rCBF study was done using the 133Xe intracarotid injection method and a 254 multi-detector camera. CT [computed tomography] scan was done 24 h after the rCBF study. Focal cerebral hyperemia was found in 16 patients. The study revealed 3 different types of hyperemia. Border-zone hyperemia, surrounding ischemic areas, was seen in patients with occluded arteries on angiography, presumably resulting from accumulation of acid metabolites in the border-zone of acute infarcts. Postischemic hyperemia was seen in patients witohout occlusion, presumably due to recanalization of a prior occluded artery. Remote hyperemia was found distant from the infarcted area, presumably due to local tissue pressure on brain tissue. Cortical infarcts (10 patients) all had extensive hyperemic areas. Because the 254 detector camera has an excellent resolution in the cortical surface, apparently all acute cerebral infarcts are, in fact, associated with hyperemic areas. The hyperemic areas are often extensive and vascular reactivity is commonly impaired. Treatment aimed at reducing blood flow in hyperemic areas might improve prognosis.