Japanese
Title老人の慢性硬膜下血腫における脳循環動態
Subtitle原著
Authors星豊*, 布施正明*, 飯尾正宏**, 藤原敬悟*, 川口新一郎**, 村田啓**, 千葉一夫**, 山田英夫**
Authors(kana)
Organization*東京都養育院附属病院 脳神経外科, **東京都養育院附属病院 核医学放射線部
Journal核医学
Volume15
Number1
Page9-15
Year/Month1978/2
Article原著
Publisher日本核医学会
Abstract「はじめに」ヒトの脳血流動態は, KetyとSchmidtが1945年にN2Oを用いて平均脳血流量と酸素消費量を測定したのにはじまる. それ以来, 脳循環測定法が改良されて, 1961年にLassenとIngvarは85Kr clearance法による局所脳循環測定法を開発した. その結果は以前に増して種々な脳の生理状態や病態生理に関する多くの脳循環の報告がされるようになった. しかもより生物学的半減期が短かくphotonの多い133Xeの応用とγカメラ - コンピュータシステムの利用, γカメラ - Data store playbackシステムが全脳半球や種々の関心領域 (ROI) での局所脳循環測定を容易にした. そこでわれわれは68歳以上の老人における慢性硬膜下血腫5例について手術前後の脳循環測定を行い, 臨床症候と脳循環動態の関係そして予後との関係を検討し, 興味ある知見を得たので若干の考察を加えた.「I. 症例と方法」対象患者の年齢, 性別, 血腫側, 脳血管撮影, 臨床症候, 検査結果はTable 1に示した. 5例についての測定方法は八光エラスター19ゲージのテフロン針で経皮的に内頸動脈選択穿刺を行い, コンレイ(R)注入によってエラスターが内頸動脈に入っていることをX線上で確認した後, 生理的食塩水4mlに溶解した133Xeを2-3 secでゆっくり注入した.
Practice臨床医学：一般
Keywords
English
TitleRegional cerebral blood flow in older patients with chronic subdural hematoma
SubtitleOriginal Articles
AuthorsYutaka HOSHI*, Masaaki FUSE*, Masahiro IIO**, Keigo FUZIWARA*, Shinichiro KAWAGUCHI**, Hazime MURATA**, Kazuo CHIBA*, Hideo YAMADA**.
Authors(kana)
Organization*Department of Surgery, Division of Neurosurgery, Tokyo Metropolitan Geriatric Hospital (Yoikuin), **Department of Nuclear Medicine and Radiological Sciences, Tokyo Metropolitan Geriatric Hospital (Yoikuin)
JournalThe Japanese Journal of nuclear medicine
Volume15
Number1
Page9-15
Year/Month1978/2
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary] Regional cerebral blood flow (rCBF) was measured in 4 regions (frontal, parietal, occipital, and temporal) over the entire hemisphere using modified 133Xe clearance method of Lassen and Ingvar in 5 patients with chronic subdural hematoma. Clearance curves obtained from the cerebral hemisphere were resolved into two mono-exponential clearance functions. Those are considered to corresponded to the flow in the grey and the white matter. Graphical analysis of the original curve allowed the estimation of the relative weight of these two tissue components as well as of the mean cerebral blood flow. In 5 patients, regional cerebral blood flow was measured both pre- and post- operation and those values were compared. CBF (average cerebral blood flow) measurements were compared. CBF (average cerebral blood flow) measurements were carried out in each patients respectively, that is before the operation and 3 weeks after the operation. Before the operation, the presence of chronic subdural hematoma, but brought about only slight or moderate generalized decrease in rCBF. The older patients presented subnormal values of 31.5-45.1 ml/100g/min. Mean fg (the flow in the grey matter) of 5 patients was 66.8+-5.0 ml/100 g/min on the hematoma site, 58.1+-2.8 ml/100 g/min on the non-hematoma site before operation. Three weeks after operation mean fg was 65.5+-7.6 ml/100 g/min on the non-hematoma site, 64.2+-3.5 ml/100 g/min on the hematoma site, and CBFr of non-hematoma site was 40.2+-5.7 ml/100 g/min and that of hematoma site, 38.5+-8.8 ml/100 g/min. These figures are moderately smaller than that of the normal values. A comparison between regional flow values noted in patients of pre- and post- operation who has a removal of hematomas indicated that the flow values of non-hematoma site increased slightly 3 weeks after operation, inspite of the only slight or no improvement in neurological features. But the flow values (fg, CBFr) of hematoma site decreased 3 weeks after operation. It seems that postoperative follow up of mean cerebral blood flow change might be of help in the assessment of prognosis of operation.
PracticeClinical medicine
KeywordsChronic subdural hematoma, Radioisotope scanning, Cerebral circulation, Cerebral atrophy, Older patients.

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