クモ膜下出血後の髄液吸収障害—クモ膜下腔線維増殖との関係

Disturbance of CSF absorption after experimental subarachnoid hemorrhage; Correlation with subarachnoid fibrosis

I．はじめに

　クモ膜下出血（SAH）に続発する慢性期の交通性水頭症の主な原因は，SAHに対する反応として起こるクモ膜下腔での線維増殖あるいは癒着であると言われており^{4-7,18,21,22）}，この病態は正常圧水頭症（normal pressurehydrocephalus，以下NPH）^1）として主に，髄液短絡術効果の評価に関連して論議されてきた．しかし，NPHの発生原因についてはいまだ明らかにされたとは言い難い．

　そこで，本研究においては，髄液吸収障害発生におけるクモ膜下腔線維増殖の意義を検索する目的で動物実験を行った．即ち，イヌにSAHを作成し，慢性期にKatzman ＆ Husseyら^9）によるsteady-state法を用いたinfusion testを行い，髄液吸収抵抗を測定し，その結果を走査電顕下に観察分類したクモ膜下腔線維増殖の程度と比較検討を行った．

Abstract

Correlation between subarachnoid fibrosis and absorption resistance of cerebrospinal fluid (CSF) after experimental subarachnoid hemorrhage (SAH) was stu-died in clogs. Scanning electron microscope (SEM) was used along with steady-state infusion method.

Experimental SAHs were produced by injecting 0.6-1.0ml/kg of blood into the cisterna magna singly, twice and three times for 11, 7 and 8 dogs respectively. All clogs were sacrificed by perfusing their brain with 10% formaldehyde solution immediately after completion of the measurement of CSF absorption resistance.