Venous stump pressure and brain damage after corticol vein occulusion

皮质静脉闭塞后的静脉残端压力和脑损伤

• 批准号: 07671537
• 负责人: YOSHIMOTO Yuhei
• 金额: $ 1.41万
• 依托单位: Dokkyo University School of Medicine
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1995
• 资助国家: 日本
• 起止时间: 1995 至 1996
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-07671537/
• 关键词: Vein; Infarction; Venons pressure; 静脈性梗塞

A canine model of cortical vein occlusion was used to evaluate whether monitoring the venous stump pressure could predict cerebral infarction after venous obstruction. Under bilateral parasagittal craniotomy, an increase in the pressure within the cortical vein in each hemisphere was directrly measured during temporary occlusion. Brain parenchymal damage 24 hours after subsequent permanent venous obstruction was classified as : stage 0 : no parenchymal damage ; stage I : mild edema ; stage II : moderate parenchymal edema and/or ischemic changes in neurous, stage III : moderate to severe hemorrhage. Histological stages correlated closely with the rise in venous pressure : mean pressure increases were 5.5(]SY+-[)2.9 mmHg in hemispheres graded as stage 0 (n=12), 7.7(]SY+-[)3.2mmHg those graded in stage I (n=5), 11.2(]SY+-[)4.1 mmHg in those classed as stage II (n=5), and 16.4(]SY+-[)5.0 in those categorized as stage III (n=7). There were significant differences between stage 0 and stage II (p<0.01), and stage 0 and stage III (p<0.001). Disruption of the blood-brain barrier as indicated by Evans blue dye extravasation correlated well with the pressure increment. These results may indicate the threshold for injury after cortical venous occlustion. Venous stump pressure measurements during a test occlusion may be a useful adjunct in predicting brain damage and be helpful for intraoperative selection for venous resection.

采用犬皮层静脉阻塞模型，评价监测静脉残端压力是否可以预测静脉阻塞后的脑梗死。在双侧颞叶旁开颅术下，在暂时闭塞期间直接测量每个半球皮质静脉内的压力增加。随后永久性静脉阻塞后24小时的脑实质损伤分类为：0期：无实质损伤; I期：轻度水肿; II期：中度实质水肿和/或神经系统缺血性变化; III期：中度至重度出血。组织学分期与静脉压升高密切相关：平均压力升高：0级半球5.5 ± 2.9mmHg（n=12），I级半球7.7 ± 3.2mmHg（n=5），II级半球11.2 ± 4.1mmHg（n=5），Ⅲ期患者16.4 ± 5.0（n=7）。0期与II期之间有显著性差异（p<0.01），0期与III期之间有显著性差异（p<0.001）。埃文斯蓝染料渗出表明血脑屏障的破坏与压力增量密切相关。这些结果可能指示皮层静脉阻塞后的损伤阈值。在测试闭塞期间测量静脉残端压力可能是预测脑损伤的有用辅助手段，并有助于术中选择静脉切除术。

项目成果

Y Yoshimoto,M Endo,T Mori,S Wakai: "Correlation between venous stump pressure and brain damage after cortial vein occlusion" J Neurosurg. (in press).

Y Yoshimoto，M Endo，T Mori，S Wakai：“皮质静脉闭塞后静脉残端压力与脑损伤之间的相关性”J Neurosurg。