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Brain and Nerve No to Shinkei Volume 38, Issue 11 （November 1986）

Brain and Nerve 脳と神経 38巻11号（1986年11月発行）

Japanese English

原著

くも膜下出血後正常圧水頭症と痴呆老人の聴覚性誘発脳幹反応 AUDITORY EVOKED BRAIN STEM RESPONSES IN THE PATIENTS OF NORMAL PRESSURE HYDROCEPHALUS FOLLOWING SUBARACHNOID HEMORRHAGE AND ELDERLY DEMENTIA PATIENTS 山口由太郎 ¹ Yoshitaro Yamaguchi ¹ ¹東京慈恵会医科大学脳神経外科 ¹Department of Neurosurgery, Jikei University School of Medicine pp.1027-1034

発行日 1986年11月1日 Published Date 1986/11/1

DOI https://doi.org/10.11477/mf.1406205802

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Abstract 文献概要
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　抄録　Normal pressure hydrocephalus （NPH）に対する脳実質機能検査として，auditory evoked brainstem responses （ABR）を行い，NPHの脳幹機能を検討した。また，痴呆老人にもABRを行いNPHと比較した。対象は，くも膜下出血（SAH）15例｛A群5例（平均年齢48.8歳），B群6例（平均年齢48.2歳），C群4例（NPH；平均年齢60.5歳）｝，老人11例｛Elderly normal group 6例（平均年齢77.5歳），Elder-ly dementia group 5例（平均年齢78.5歳）｝，健康成人8例（Younger normal group：平均年齢26.0歳）である。ABRは，I-III interpeak latency （IPL），III-V IPL,I-V IPL （CTT：central transmis-sion time）を測定した。Younger normal group, Elderly normal groupを比較すると，CTTには有意差を認めず（p＜0.05），CTTは年齢に影響されないパラメーターと考えられた。C群およびElderly normalgroupは，CTTが他例に比し，有意に延長していた（p＜0.05）が，両者間には有意差を認めなかった。以上より，SAH後NPHの病態には脳幹も関与していると推測できたが，痴呆老人もSAH後NPHと同程度の脳幹機能障害を示しており，ABRでは両者を鑑別できなかった。

There have been many reports that had discus-sed the effectiveness of shunt surgery in dementia patints. But it is not always reliable to predict such effectiveness before the operation. We used auditory evoked brain stem responses (ABR) to investigate the degree of brain damage in normal pressure hydrocephalus (NPH) and predict the effectiveness of shunt surgery.

Fifteen patients with subarachnoid hemorrhagewere divided into three groups, 5 cases without any symptoms of NPH, 6 cases with one of three symptoms of NPH and 4 cases with full blown symptoms of NPH which improved after shunt surgery, it is NPH. Eleven cases of aged patients were classified into two groups, Elderly normal (6 cases) and Elderly dementia (5 cases) groups, Younger normal group was composed of 8 healthy persons. Interpeak latencies (IPL' s) on ABR was used as indexes of evaluating brain stem function, I -V IPL was used as central transmission time (CTT).

CTT of Younger normal group and Elderly nor-mal group were not different. It showed that CTT was a reliable parameter of ABR independently of age. There was significant prolongation of CTT in the patients of NPH and Elderly dementia group in comparison with other groups, However between them significant differences were not present.

We concluded that there was some degree of brain stem dysfunction in the patients of NPH as well as dementia patients suggesting one aspect of the pathogenesis of NPH. But we could not distinguish the patients of NPH from other de-mentia patients by the analysis of ABR.