このエントリーをはてなブックマークに追加
ID 16206
Eprint ID
16206
フルテキストURL
Thumnail 97_783.pdf 3.11 MB
タイトル(別表記)
A study of cerebral hemodynamics in extracranial-intracranial arterial anastomosis after middle cerebral artery occlusion
著者
山本 祐司 岡山大学医学部脳神経外科教室
抄録
In order to evaluate extracranial-intracranial arterial anastomosis in acute ischemic stroke, changes in the local cerebral blood flow (lCBF) in the cortical and subcortical areas were investigated by hydrogen clearance during left middle cerebral artery (MCA) occlusion and maxillary artery (MA)-to-MCA anastomosis in 24 mongrel dogs. Following MCA occlusion, the lCBF was maintained at more than 25ml/100g/min in 17 dogs because of effective leptomeningeal collaterals. In seven dogs, cortical ischemia was shown with progressive lCBF reduction to below 25ml/100g/min. Severe persistent ischemia of less than 10ml/100g/min was not observed. Subcortical ischemia with lCBF reductions to below 25ml/100g/min in the gray matter and below 10ml/100g/min in the white matter occurred more frequently than cortical ischemia. Following MA-MCA anastomosis, the cortical lCBF returned to nearly the preocclusion value, and the subcortical lCBF showed a slight or moderate increase. Reactive hyperemia was noted in two dogs (at three sites), but marked hyperemia was not abserved in any of the animals. The increase in the lCBF after the anastomsis showed a linear relationship to the donor arterial supply. Postmortem and histological examinations revealed no cerebral edema or hemorrhagic infarct. Comparative analyses of these results with the concept of "ischemic penumbra" led to the conclusion that cerebral ischemia with the cortical lCBF ranging from 15 to 25ml/100g/min (30 to 50% of the preocclusion value) after MCA occlusion cannot be reversed even by the leptomeningeal collaterals and may produce progessive neurological dysfunction. In such an ischemic condition, rapid restoration of the lCBF by extracranial-intracranial arterial anastomosis might be effective in the prevention of cerebral infarction as well as in the recovery of neuronal function.
キーワード
頭蓋外―頭蓋内動脈吻合術
経眼窩的中大脳動脈閉塞
水素クリアランス法
脳循環動態
脳虚血
発行日
1985-10-30
出版物タイトル
岡山医学会雑誌
出版物タイトル(別表記)
Journal of Okayama Medical Association
97巻
9-10号
出版者
岡山医学会
出版者(別表記)
Okayama Medical Association
開始ページ
783
終了ページ
803
ISSN
0030-1558
NCID
AN00032489
資料タイプ
学術雑誌論文
オフィシャル URL
https://www.jstage.jst.go.jp/article/joma1947/97/9-10/97_9-10_783/_article/-char/ja/
関連URL
http://www.okayama-u.ac.jp/user/oma/index.html
言語
Japanese
著作権者
岡山医学会
論文のバージョン
publisher
査読
有り
Eprints Journal Name
joma