大泉門拍動波の分析（第1報）—拍動波形と頭蓋内圧の関係について

ANALYSIS OF "ANTERIOR FONTANELLE PULSATION WAVE"PART 1: RELATIONSHIP BETWEEN INTRACRANIAL PRESSURE AND "ANTERIOR FONTANELLE PULSATION WAVE"

I．はじめに

　脳はある一定の規律をもつた運動をする。そして脳の運動は（1）心拍と同期するcyclicな拍動性々質と（2）呼吸の周期に従うゆつくりとした動きを有することは周知の事実である。

　脳の拍動の起源が真に動脈由来であるものか，純粋に静脈に由来するものであるか，または脳室のchoroidPlexusのpump action^2）によつて生じるものか，現在なお定説はない。

No definite relationship has been established be-tween the CSF pulse wave pattern and the intra-cranial pressure.

Noto (1935), Gerlach (1952) and Grote (1964) studied the relationship between the intracranial pressure and the wave-shape of the CSF pulse wave that was recorded indirectly via the scalp over the defect in the skull or via the anterior fontanelle in the infant.

The authors reported the results that were ob-tained by analysis of the CSF pulse wave via the anterior fontanelle of the infant with Marey's tambour.

The "anterior fontanelle pulsation wave" thus obtained compared with the intracranial pressure determined by Purin's method (1964) via the anterior fontanelle. Modified Purin's instruments were used in this experiment. The "anterior fontanelle pulsa-tion wave" was analyzed and the following results were obtained.

1) A significant correlation between the Up-stroke time (U-time) and the intracranial pressure was not obtained. However prolongation of the U-time was noted after the shunting operation in hydrocephalic infants and in one case after reduction of the intracranial pressure by ventricular puncture. These facts suggest that the U-time of the in-dividual case are significantly related to the intra-cranial pressure before and after surgical procedure which change the CSF pressure.

2) The relationship between the intracranial pressure determined via the anterior fontanelle and the "incision coefficient" was investigated. A posi-tive correlation was noted between the "incision coefficient" and the intracranial pressure.