The vascular factor in intracranial pressure and the maintenance of the cerebrospinal fluid circulation.
The vascular factor in intracranial pressure and the maintenance of the cerebrospinal fluid circulation.
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DOI：
10.1093/brain/66.3.204
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发表时间：
1943-01-01
期刊：
影响因子：
14.5
通讯作者：
O'Connell, JEA
中科院分区：
文献类型：
--
作者：
O'Connell, JEA
正常的颅内正压受血管和流体静力因素的极大影响，其中四分之三的压力可归因于这些因素。对由呼吸和血液循环引起的、通过腰椎穿刺、枕下穿刺和脑室穿刺所测量的脑脊液压力变化进行了全面分析。结论是，腰椎穿刺、枕下穿刺和脑室穿刺结果的差异是人为的，是由测量的机械因素造成的。脑脊液压力有节律的波动是每3或4秒80毫米，但如果用普通的细针测量（通常不那么明显）。如果在坐姿下测量，脑脊液压力随头部位置（屈曲、伸展）而变化，差值为70毫米。呼气和心脏收缩期颅内血容量的增加被认为主要发生在颅底，使脑脊液向矢状窦上方移位。作者假定脑脊液流入蛛网膜绒毛的节律性波动导致其增大，而这些又导致了外侧陷窝的形成。最后，试图将上述生理机制应用于对神经病理和神经临床特征的解释。
Normal positive intracranial pressure is greatly influenced by vascular and hydrostatic factors, to which 3/4 of the pressure may be ascribed. The variations of cerebrospinal pressure, caused by respiration and by blood circulation, and measured by lumbar, sub-occipital and ventricular puncture, are thoroughly analyzed. It is concluded that the variations in the results from lumbar, suboccipital and ventricular puncture, are artificial and caused by mechanical factors of measuring. The rhythmical fluctuation of cerebrospinal pressure is 80 mm. every 3 or 4 secs., but (is usually not as marked) if measured with common narrow needles. The cerebrospinal pressure, if measured in the sitting position, varies with the position of the head (flexion, extension), the difference being 70 mm. The increase in intracranial blood volume during expiration and systole is believed to occur mainly in the basal part of the cranium, displacing cerebrospinal fluid towards the superior sagittal sinus. The author assumes that the rhythmic fluctuation of the afflux of cerebrospinal fluid into the arachnoidal villi causes their enlargement and these, in turn, are responsible for the formation of the lacunae laterales. Finally, an attempt is made to apply the aforementioned physiological mechanisms to an explanation of neuropathological and neuroclinical features.