腦脊髄液腔内液量と液壓變動に關する臨床實驗的研究

Clinical and Experimental Studies on the Relation between the Changes of the Liquid Measure and the Fluctuations of the Liquid Pressure in the Cerebrospinal Cavity.

1．緒言

　脳脊髄液壓に關する研究は古來種々の實驗を基として論ぜられているが未だ定説が無い。然し一般に正常液壓は靜力學的壓によつて定められ，之に彈力膜壓，動靜脈壓，及び所謂分泌壓等の影響が加わつているものと考えられている。又病的液壓の變動に就いては專ら臨床的觀察に負うもので，其の發生機序に關する實驗的研究は殆んど行われていない。更に近時冶療醫學の發達に從い各種藥物，血清等の髄液内注射，脳室撮影，脳脊髄液腔の洗滌，髄液の除去，Pumping等脳脊髄液腔内に生理的或は化學的變化を與える治療法が盛んに利用されているにもかゝわらず，かゝる際の液壓の變化，並に其の臨床症状へ及ぼす影響等に關しては殆んど見るべき報告が無い。

　山角は昭和24年春以來，精神病患者の脳髄を圍む液體環境を變化せしめる目的で「脳室灌流」を行い，第47回日本精神神經學會に報告した。而してこの研究の一部として，吾々は脳脊髄液腔内液量の増減に依り液壓は如何なる態度を示すか，又液量の増減或は液壓の變化は臨床症状に如何なる影響を及ぼすか等に就て檢討し，脳脊髄液壓變動に關する研究に一資料を提供せんとしたのである。

Since 1949 the ventricle perfusion has been practiced as the remedial treatmen for the 23 cases of psychoses. As a part of this studies, we observed the following: through the changes of the quantity of liquid in the cerebrospinal cavity by the use of physiological salt water, the changes of the liquid pressure and the influence upon clinical symptoms were resear-ched. So far as this experimental research is concerned, the relation between the changes of liquid measure and the fluctuations of the li-quid pressure in the cerebrospinal cavity is not necessarily regular. But throgh the increase or decrease of the liquid measure in the cavity by more than about 16cc, the ascendance or descendance of the liquid pressure was ascer-tained. And it was found that, when conside-rably much quantity of the physiological salt water is irrigated, the liquid pressure fluctua-tes temporarily, i.e. after it ascends for the time being it descends again till it approaches the equilibrium liquid pressure. It was dis-covered to stay at 200~24mm, even when the liquid in the cerebrospinal cavity is increased in quantity by the one third of that in the normal condition.

During the practice of this experiment, some symptoms, such as headache, disgust, vomit, uneasiness, paleness of faces, perspiration of faces, inclination for the stool, etc. were found. There are recognised as the symytoms which are related not so much with the increase or decrease of the liquid measure in the cavity or the fluctuation of the liquind pressure dur-ing the experiment as with the duration of time of perfusion.