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Brain and Nerve No to Shinkei Volume 42, Issue 3 （March 1990）

Brain and Nerve 脳と神経 42巻3号（1990年3月発行）

Japanese English

原著

脳静脈還流障害の局所脳血流および虚血性脳浮腫に及ぼす影響 THE EFFECTS OF DISTURBANCE OF CEREBRAL VENOUS DRAINAGE ON FOCAL CEREBRAL BLOOD FLOW AND ISCHEMIC CEREBRAL EDEMA 由良茂貴 ¹ , 佐古和廣 ¹ , 米増祐吉 ¹ Shigeki Yura ¹ , Kazuhiro Sako ¹ , Yukichi Yonemasu ¹ ¹旭川医科大学脳神経外科 ¹Department of Neurosurgery, Asahikawa Medical College キーワード： cerebral ischemia , cerebral blood flow , brain edema , autoradiography , cerebral venous drainage Keyword: cerebral ischemia , cerebral blood flow , brain edema , autoradiography , cerebral venous drainage pp.269-275

発行日 1990年3月1日 Published Date 1990/3/1

DOI https://doi.org/10.11477/mf.1406900031

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Abstract 文献概要
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　脳静脈還流障害の急性期虚血性脳浮腫発生に与える影響をラット中大脳動脈閉塞モデルにおいて検討した。脳静脈還流障害は両側外頸静脈を結紮する事により行なった。虚血2時間において局所脳血流量（LCBF）を¹⁴C-iodoantipyrine（¹⁴C-IAP）による定量的オートラディオグラフィー法で測定し，局所脳水分含有量の変化をgradient column法にて検討した。両側外頸静脈結紮によって，外頸静脈圧は約100mmH₂0上昇した。虚血2時間において両側外頸静脈閉塞群では虚血巣の広がりがコントロール群に比較して広範囲で虚血の程度も強く認められた。また水分含有量増加も中大脳動脈の還流域全般においてより強く認められた。以上より心不全，肺高血圧症，上気道閉塞，持続陽圧換気，Trendelenburg posture, Valsalva’smanuevreなど種々の原因による全身静脈圧の上昇，および脳静脈還流障害は局所脳虚血において虚血巣を広範かつ高度にし，疾患の予後を悪くする事が示唆された。またその機序として虚血性脳浮腫発生の程度が関与していると推測された。

The effect of disturbance of cerebral venous dra-inage on acute ischemic cerebral edema and cere-bral circulation were studied by measuring local cerebral blood flow (LCBF) and local changes in brain water content using a middle cerebral artery (MCA) occlusion model. Rats were anesthetized with halothane and the stem of the left MCA was occluded. Disturbance of cerebral venous draina-ge was induced by bilateral occlusion of the exter-nal jugular veins, i. e., the right external jugular vein was cannulated and the left one was occluded by a clip. LCBF was measured by the ¹⁴C-iodo-antipyrine (¹⁴C-IAP) autoradiographic method at 2 hours after MCA occlusion. Local changes in brain water content were studied 2 hours after MCA occlusion by measuring the specific gravity of cerebral tissue in the gradient column with bro-mobenzene and kerosen. The control rats which underwent the same anesthesia and surgical proce-dure including the MCA occlusion and cannulation into the right external jugular veins, but which did not undergo occlusion of the left external jugular veins, were prepared and studied at the same time after MCA occlusion.

In the rats with bilateral occlusion of the exter-nal jugular veins, the external jugular venous pressure was elevated up to about 8 mmHg (100 mmH₂O) (control : 1.3 mmHg). At 2 hours after MCA occlusion, LCBF in the ischemic core was decreased. The ischemic area was more extens-ive in the rats with bilateral occlusion of the external jugular veins compared with the controls. Furthermore, specific gravity of the brain was decreased in the entire left MCA territory in the rats with bilateral occlusion of the externaljugular veins.

Our data indicate the possibility that the distur-bance of cerebral venous drainage and the increase in systemic venous pressure associated with the various conditions, for example, cardiac failure, pul-monary hypertension, obstruction of the air way,continuous positive pressure ventilation, Trendel-enburg posture, Valsalva's maneuvre and so on, enlarge the ischemic area, and exacerbate the is-chemic brain edema.