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Brain and Nerve No to Shinkei Volume 28, Issue 6 （June 1976）

Brain and Nerve 脳と神経 28巻6号（1976年6月発行）

Japanese English

原著

正常頭蓋内圧環境—開放腔と閉鎖腔の理論 NORMAL INTRACRANIAL CIRCUMSTANCES:THE THEORY OF "THE OPEN AND THE CLOSED CAVITIES" 池山淳 ¹ , 前田成 ¹ , 坂野公一 ¹ , 伊藤明雄 ¹ , 永井肇 ¹ , 景山直樹 ¹ Atsushi Ikeyama ¹ , Shigeru Maeda ¹ , Koichi Banno ¹ , Akio Ito ¹ , Hajime Nagai ¹ , Naoki Kageyama ¹ ¹名古屋大学医学部脳神経外科 ¹Department of Neurosurgery, Nagoya University, School of Medicine pp.539-547

発行日 1976年6月1日 Published Date 1976/6/1

DOI https://doi.org/10.11477/mf.1406203890

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Abstract 文献概要
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I．はじめに

　前報告^6,7,10）で，著者らは，頭蓋内圧を頭蓋内内容物質容積の関数とみる立場（容積圧）^12,13,16）と，動静脈系を介して与えられる圧力の関数とみる立場（反映圧）の両方からみることが出来ることを示し，これが相互に矛盾しないことを理論的に示した^10）。この反映圧の概念は，容積圧の概念では解釈され難い生体現象を容易に理解させうるので非常に有用な考え方である。そこで著者らは，従来から取扱われていた頭蓋内圧をこの反映圧の概念を適用して見直す必要があると考えた。本論文では，正常頭蓋内圧力環境を知る目的で20例の臨床例の腰椎穿刺圧について検討を行つた。

In the previous report, we proposed the conceptof the driving pressure and the pressure trans-mission rate η to analyze the intracranial pressure.In that report the point of view that the intra-cranial pressure is considered as the transmittedpressure from the vascular system was theoreticallyestablished. In the present paper, normal intra-cranial circumstances is analyzed by the conceptof the driving pressure in 20 cases with normalCSF pressure.

1: The lumbar pressures measured by the closedrecording and the open recording were compared.The closed recording denotes the measurement ofthe CSF pressure without any loss of the CSF.The open recording means the measurement of theCSF pressure by the open manometer in which thepressure and fluctuation were measured at the stop-cock level by the pressure transducer. Small de-crement of the mean pressure and marked decreaseof the pulse pressure were observed when the closedrecording was switched to the open recording.

2: The mean pressure change by the removal of1ml of CSF was 7.6mmAq/ml.

3: The pressure transmission rates of the meanpressure and of the puse pressure were calculated.ηm was 6.05×10^-2. ηHB was 2.26×10^-2.ηRespwas 5.11×10^-2.

From these observations normal cranial cavityapparently has characteristics of the open cavity.The reason why the cranial cavity seems to be anopen cavity can be explained by following 3 factorsnamely 1, CBF, that is, balance of in flow and outflow of the blood into and from the cranial cavity,2, CSF circulation and 3, the tension of the wallsin the cerebrovascular resistance vessels.

It is concluded that disturbances of any one ofthese 3 mechanisms make the cranial cavity closed,and that in the pathological condition the intra-cranial pressure tends to be determined by thesystemic blood pressure. The point of view whetherthe cranial cavity is either open or closed is signi-ficant to analyze the intracranial pressure.