실험적 뇌압박

초록

The patterns of experimental brain herniation and distortion were studied during expansion of supratentorial balloons and laminarias in cats and rabbits. The risk of brain herniation has been noted to be greater in rapidly evolving expanding lesion with balloons than the more slowly developing supratentorial lesion with laminarias. The region of brain beneath the lesion failed to fill with vital dye, Evans Blue, indicating ischemia with decrease in or cessation of cerebral blood flow in this region. Ischemia was widely spread throughout the brain with relative sparing of area of basal ganglia. The cerebrovascular architecture in various portions of the brain compressed by the mass was assessed by intravasrular staining with benzidine and nitroprusside oxidase reaction. Complete collapse and thrombosis of large surface and perforating vessels were striking immediately subjacent to the mass. The hemorrhagic area along with severe capillary obliteration on underlying midbrain was observed. Histopathologic picture 9f the brain under the compression revealed several different degree of cerebral damage. Under the mild damage, main histologic picture was acute exudative meningitis aid moderate damage revealed disappearance of meninges and superficial area of the cerebral cortex. The marked damage revealed extensive wide damage of the brain substance under the compression associated marked hemorrhage and edema, The cerebral damage in different degree seemed to be dependent rather on the speed of expansion of the compressing mass than on the size of the mass itself.