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NEUROFUNCTIONAL DISTURBANCES AS RELATED TO CORTICAL ISCHEMIA AND WHITE MATTER ISCHEMIA Kazuo Kataoka 1 , Toru Hayakawa 1 , Rudolf Graf 2 , Kazuo Yamada 1 , Ryotaro Kuroda 3 , Makoto Abekura 1 , Heitaro Mogami 1 , Wolf-Dieter Heiss 2 1Department of Neurosurgery, Osaka University Medical School 2Max-Planck Institute for Neurological Research 3Department of Neurosurgery, Kinki University Medical School pp.117-124
Published Date 1989/2/1
DOI https://doi.org/10.11477/mf.1406206249
  • Abstract
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We evaluated regional cerebral blood flow (rCBF) by means of hydrogen clearance method as well as [14C]-iodoantipyrine autoradiographic method, cortical auditory evoked potentials (AEP), somatosentory evoked potentials (SEP) induced by forelimb (median nerve) stimulation (SEP-F), and SEP induced by hindlimb (tibial nerve) stim-ulation (SEP-H) in cats after occlusion of the left middle cerebral artery (MCA) under alpha-chloralose anesthesia. According to the degree of ischemia, the experimental animals were divided into two groups. One was the critical ischemia which was defined as permanent total suppression of AEP, and low residual blood flow in the auditory cortex. And the other was the non-critical ischemia which included transient suppression and spontaneous recovery of the cor-tical sensory evoked potentials, and high residual blood flow (>15 ml/100 g/min). In one cat with transient suppression of three kinds of sensoryevoked potentials, the [14C]-iodoantipyrine (IAP) autoradiograph revealed only a limited ischemic area of subcortical white matter. In the critical ischemia group, ischemia of the primary sensory cortex ranged from the mostly affected primary auditory cortex (supplied by the MCA) to the least affected hindlimb projection area within primary somatosensory cortex (supplied by the ACA). The forelimb projection area of the primary somatosensory cortex (supplied by both ACA and MCA) showed a mild or moderate reduction of rCBF after occlusion. The [14C]- IAP autoradiograph showed severe reduction of the white matter including the somatosensory pathway in the wide range. However, rCBF in the thalamus and hindlimb projection area within somatosensory cortex was almost intact in the cat with critical ischemia. These rCBF studies concluded that the suppression of AEPs was at-tributable to cortical ischemia, and the suppres-sion of SEP was attributed to white matter ischemia. We analyzed the acute sequential changes of multimodality evoked potentials (AEP, SEP-F, and SEP-H) using a multiplex stimulation and analysis system. AEPs were abolished within 3 min. after occlusion, whereas the decrease in SEP-Hs started after about 5 minutes, then SEP-Hs disappeared within 10 minutes. According to SEP-F two components of the SEP changes were shown : an early immediate reduction and a later decrease occurring about 5 minutes after occlusion. This time lag possibly reflects the resistance of the white matter to ischemia, compared to cortex.


Copyright © 1989, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 2185-405X 印刷版ISSN 0006-8969 医学書院

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