THRESHOLDS OF FOCAL CEREBRAL-ISCHEMIA IN AWAKE MONKEYS
THRESHOLDS OF FOCAL CEREBRAL-ISCHEMIA IN AWAKE MONKEYS
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DOI：
10.3171/jns.1981.54.6.0773
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发表时间：
1981-01-01
影响因子：
4.1
通讯作者：
OJEMANN, RG
中科院分区：
文献类型：
--
作者：
JONES, TH;MORAWETZ, RB;OJEMANN, RG
一个清醒的灵长类动物模型已经开发，允许可逆大脑中动脉闭塞在生理监测。这种方法消除了麻醉的缺血修饰作用，并允许神经功能与脑血流量（CBF）和神经病理学的相关性。用该模型评价大鼠脑对局灶性脑缺血的耐受性。中动脉闭塞15或30分钟，2-3小时或永久。连续监测评估神经功能、局部CBF （H2清除率）和其他生理参数（血压、血气和颅内压）。2周后，神经病理学评估确定梗死及其与血流记录部位的关系。中动脉闭塞通常导致局部脑血流显著减少。流量的不同减少与赤字的不同严重程度直接相关。在长达3小时解除闭塞导致临床改善。病理检查显示，缺血15-30分钟后显微镜下可见梗死灶，缺血2-3小时后出现中度至大面积梗死，大多数病例永久性MCA闭塞后出现大面积梗死。局部脑血流似乎定义了麻痹和梗死的阈值。当局部流量低于。apprx。23 cm3/100 g / min，出现可逆性麻痹。当局部血流在2-3小时内低于10-12 cm3/ 100g / min或在永久性闭塞期间低于17-18 cm3/ 100g / min时，观察到不可逆的局部损伤。有些急性偏瘫，血流量在瘫痪范围内，可通过手术血运重建术改善。
An awake-primate model has been developed which permits reversible middle cerebral artery (MCA) occlusion during physiological monitoring. This method eliminates the ischemia-modifying effects of anesthesia and permits correlation of neurological function with cerebral blood flow (CBF) and neuropathology. The model was used to assess the brain''s tolerance to focal cerebral ischemia. The MCA was occluded for 15 or 30 min, 2-3 h or permanently. Serial monitoring evaluated neurological function, local CBF (H2 clearance) and other physiological parameters (blood pressure, blood gases and intracranial pressure). After 2 wk, neuropathological evaluation identified infarcts and their relation to blood flow recording sites. MCA occlusion usually caused substantial decreases in local CBF. Variable reduction in flow correlated directly with the variable severity of deficit. Release of occlusion at up to 3 h led to clinical improvement. Pathological examination showed microscopic foci of infarction after 15-30 min of ischemia, moderate to large infarcts after 2-3 h of ischemia and in most cases large infarcts after permanent MCA occlusion. Local CBF appeared to define thresholds for paralysis and infarction. When local flow dropped below .apprx. 23 cm3/100 g per min, reversible paralysis occurred. When local flow fell below 10-12 cm3/100 g per min for 2-3 h or below 17-18 cm3/100 g per min during permanent occlusion, irreversible local damage was observed. Some cases of acute hemiplegia, with blood flow in the paralysis range, might be improved by surgical revascularization.