The use of stable xenon-enhanced computed tomographic studies of cerebral blood flow to define changes in cerebral carbon dioxide vasoresponsivity caused by a severe head injury.

The use of stable xenon-enhanced computed tomographic studies of cerebral blood flow to define changes in cerebral carbon dioxide vasoresponsivity caused by a severe head injury.
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使用稳定的氙气增强计算机断层扫描研究脑血流来确定严重头部损伤引起的脑二氧化碳血管反应性的变化。

DOI:
10.1097/00006123-199112000-00011
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发表时间:
1991
期刊:
影响因子:
4.8
通讯作者:
Bouma,GJ
Bouma,GJ
中科院分区:
医学1区
文献类型:
--
作者:
Marion,DW;Bouma,GJ

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以前的研究使用氙-133脑血流量(CBF)的方法已经证明了损害的CO 2血管反应性后,严重的头部损伤,但只有全球的价值可以得到可靠的这项技术。我们使用稳定的氙增强计算机断层扫描CBF方法研究了CO2血管反应性,该方法提供了氙-133方法无法获得的有关明确的皮质区域和深部脑结构的信息。在17例入院时格拉斯哥昏迷量表评分为8分或更低的患者中,半球CO2血管反应性范围为1.3 - 8.5%/mmHg CO2分压变化。脑叶、小脑、基底节和脑干的CO2血管反应性经常与平均值相差25%以上。除1例患者外,所有患者的一个或多个上述区域的局部CO2血管反应性与总体平均值相差超过50%。最大的变异性发生在急性硬膜下血肿和弥漫性(双半球)损伤的患者中。这种CO2血管反应性的变异性对于有效和安全地治疗经常伴随严重颅脑损伤的颅内高压具有重要意义。(神经外科29:869-873,1991)
Previous studies using the xenon-133 cerebral blood flow (CBF) method have documented the impairment of CO 2 vasoresponsivity after a severe head injury, but only global values can be obtained reliably with this technique. We studied CO 2 vasoresponsivity using the stable xenon-enhanced computed tomographic CBF method, which provided information about well-defined cortical regions and deep brain structures not available with the xenon-133 method. In 17 patients with admission Glasgow Coma Scale scores of 8 or less, hemispheric CO 2 vasoresponsivity ranged from 1.3 to 8.5% per mm Hg change in partial CO 2 pressure. Lobar, cerebellar, basal ganglia, and brain stem CO 2 vasoresponsivity frequently varied from the mean global value by more than 25%. In all but one patient, local CO 2 vasoresponsivity in one or more of these areas differed from the mean global value by more than 50%. The greatest variability occurred in patients with acute subdural hematomas and diffuse (bihemispheric) injuries. This variability in CO 2 vasoresponsivity has important implications for the effective and safe management of intracranial hypertension that frequently accompanies severe head injury.(Neurosurgery 29: 869-873, 1991)
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