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Experimental and clinical studies on the damage of the brain parenchyma in the disturbance of the cerebrospinal fluid hydrodynamics.

脑脊液流体动力学紊乱对脑实质损伤的实验和临床研究。

基本信息

批准号：
01570811
负责人：
TAMAKI Norihiko
金额：
$ 1.34万
依托单位：
Kobe University
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (C)
财政年份：
1989
资助国家：
日本
起止时间：
1989 至 1991
项目状态：
已结题

项目摘要

The influence of the disturbance of cerebrospinal fluid dynamics on the damage of the brain parenchyma and the mechanism of hydrocephalic symptoms were studied on the basis of the clinical findings and the experimental investigations. In experimental studies using hydrocephalic models produced by injection of kaolin into the cisterna magna of rabbits and dogs, content of the free water increased and that of the found water decreased in the periventricular white matter at the acute and subacute stages of hydrocephalus. At these stages content of both free and bound water did not change in the cortical gray matter. The ratio of the free to bound water content recovered near the control values. The energy metabolism was deranged in the periventricular white matter at both acute and subacute stages and recovered near the normal state at the chronic stage. In clinical studies the cerebral blood flow of the supratentorial structures decreased in all stages of hydrocephalus. There was also a disturbance of hemodynamics of the cerebellum as a remote effect. There was a recovery of hemodynamics of the cerebrum as well as the cerebellar structures after cerebrospinal fluid shunting. It is suggested from the result of experimental and clinical studies that increase in free water content in the periventricular white matter may produce disturbance of the cerebral energy metabolism and the cerebro-cerebellar blood flow. As a result of these morphological and functional disturbances the clinical symptoms and signs of hydrocephalus may occur.

本文在临床和实验研究的基础上，探讨了脑脊液动力学紊乱对脑实质损害的影响及脑积水症状的发生机制。用家兔和狗枕大池注射高岭土造成脑积水模型，在脑积水急性期和亚急性期，脑室周围白色物质中游离水含量增加，游离水含量减少。在这些阶段，自由和束缚水的含量没有改变皮质灰质。游离水与结合水含量的比值恢复到接近对照值。急性期和亚急性期脑室周围白色物质能量代谢紊乱，慢性期恢复至接近正常状态。在临床研究中，幕上结构的脑血流量在脑积水的各个阶段都有所减少。小脑的血流动力学紊乱也是一种远期效应。脑脊液分流后，大脑和小脑结构的血流动力学恢复。实验和临床研究结果提示，脑室周围白色质内自由水含量的增加可能引起脑能量代谢和小脑-小脑血流的紊乱。由于这些形态和功能障碍，可能出现脑积水的临床症状和体征。