start-ver=1.4 cd-journal=joma no-vol=82 cd-vols= no-issue=7-8 article-no= start-page=361 end-page=372 dt-received= dt-revised= dt-accepted= dt-pub-year=1970 dt-pub=19700831 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Studies on acid base balance of the cerebrospinal fluid under acute intracranial hypertension kn-title=急性頭蓋内圧亢進時の髄液酸塩基平衡に関する研究 en-subtitle= kn-subtitle= en-abstract= kn-abstract=The author devised on pparatus for continuous monitoring of acid base balance of CSF without any CSF exposure to the atomosphere. The apparatus is an extracorporeal "ventriculo-cisternal circulation system" which is consisted of pressure pump, glass capillary electrode, Clark PO(2) eleotrode and Severinghaus Pco(2) electrode, all-lined up on a stainless steal conduit betweeen lateral ventricle and cisterna magna. In the experimental cases of 5 dogs, the ventriculo-cisternal circulation system was used for monitoring acid base balanec of the CSF under acute intracranial hypertension produced by extradural balloon inflation. The blood Pco(2) was constantly watched during experiment to be kept in the normal range by means of a respirator. Pco(2) in the CSF began to increase in early stage above the pressure of CSF of 300 mmH(2)O and incseased more and more in parallel with raised pressure. HCO(3)- in the CSF was decreased when acute and more severe intracranial hypertension was maintained for hours. Hypercapnic acidosis and metabolic acidosis occured in the CSF specifically when the intracranial pressure was raised acutely. Clinically, acid base balance of the CSF was studied on acute intracranial hypertension of three patients who suffered from brain tumor. Intracranial pressure was monitored continuously by pressure gauge transducer connected to the ventricular drainage. In this clinical research, CSF, arterial blood and jugular blood were sampled for measurement. Pco(2) in the CSF was increased when the intracranial pressure was elevated above 500mmH(2)O and metabolic acidosis was added when the pressure was more elevated continued. That is to say, CSF became acidosis as same as experimental results. On the contrary, arterial blood became respiratory alkalosis when the intracranial pressure was elevated to 500-1000mmH(2)O. This phenomenon suggest that increse of hydrogenic ions induced by intracranial hypertension stimulates respiratory center. Hypercapnic acidosis and metabolic acidosis occur specifically in the CSF independently from the change in the blood when the intracranial pressure rises. Namely, the acid base balance of the CSF can not evaluated from that of the blood. The author adovocates this state is hidden acidosis. en-copyright= kn-copyright= en-aut-name=DoiAkihiro en-aut-sei=Doi en-aut-mei=Akihiro kn-aut-name=土井章弘 kn-aut-sei=土井 kn-aut-mei=章弘 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部脳神経外科学教室 END start-ver=1.4 cd-journal=joma no-vol=82 cd-vols= no-issue=7-8 article-no= start-page=355 end-page=360 dt-received= dt-revised= dt-accepted= dt-pub-year=1970 dt-pub=19700831 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=TWO CASES OF PRIMITIVE TRIGEMINAL ARTERY Two cases of persistent carotid basilar anastomosis are reported kn-title=case report Persistent Primitive Trigeminal Arteryの2症例 en-subtitle= kn-subtitle= en-abstract= kn-abstract=The first case is 28 years old femal who admitted with porphyrin-uria and left sided visual disturbance which was occured suddenly with vomitting. The carotid cerebral angiograpby demonstrated the occulsion of left side int. carotid artery at the point of C(2) and the primitive trigeminal artery the same side. The anastomosis to the anterior cerebral artery and the middle cerebral artery are made through this anomalous artery and Willis circle. The second case is 20 years old female who admitted with Jacksonian type seizures and no neurological signs. The cerebral carotid angiography demonstrated the primitive trigeminal artery in right side. en-copyright= kn-copyright= en-aut-name=NakajimaYoshihiko en-aut-sei=Nakajima en-aut-mei=Yoshihiko kn-aut-name=中島良彦 kn-aut-sei=中島 kn-aut-mei=良彦 aut-affil-num=1 ORCID= en-aut-name=NakamuraYoshinobu en-aut-sei=Nakamura en-aut-mei=Yoshinobu kn-aut-name=中村善信 kn-aut-sei=中村 kn-aut-mei=善信 aut-affil-num=2 ORCID= en-aut-name=ShinagawaShoji en-aut-sei=Shinagawa en-aut-mei=Shoji kn-aut-name=品川昌二 kn-aut-sei=品川 kn-aut-mei=昌二 aut-affil-num=3 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部神経精神医学教室 affil-num=2 en-affil= kn-affil=岡山大学医学部神経精神医学教室 affil-num=3 en-affil= kn-affil=岡山大学医学部神経精神医学教室 END