脑外科手术后发生正常灌注压突破的发病机制及超微病理基础

目的:探讨脑外科手术后部分患者病变邻近脑组织发生正常灌注压突破并发症的发病机制及其超微病理基础.材料和方法:对68例脑内血管畸形病变邻近的脑组织进行电子显微镜观察.结果:病灶邻近脑组织内部分毛细血管外周的星形细胞足突缺失或出现血管基膜疏松、分层等发育不良的情况,甚至有些血管壁组织结构破损.结论:电子显微镜检查证实,在血管畸形病灶周围的脑组织内可见病理性血管.该血管的基膜发生病变,血管周围的星形细胞足突明显减少或破坏.当血液灌注压力突然变化时,这种病变的血管就可能发生液体外渗及破裂.这就是在神经外科手术中或手术后发生正常灌注压突破并发症的超微病理基础.

Ultrapathology and Pathogenesis of Normal Perfusion Pressure Breakthrough during or after Neurosurgical Operation

Purpose:To explore the mechanism of pathogenesis and ultrastructural pathology of Normal Perfusion Pressure Breakthrough Syndrome (NPPB) which take place in brain tissue near by the arteriovenous malformation after operation Materials and Methods:Sixty eight cases with cerebral vascular malformation were studied in this paper The cerebral tissue around the foci of pathological changes was observed with electron microscopy Results:Some processes of astrocytes which surround the capillary vessel in the cerebral tissue near the vascular malformation were losed or the basement membrane of capillary vessel was loosen and delaminated,even some vascular walls were destroyed. Conclusion: Electron microscopy shows a kind of pathological vessel in the brain tissue surround the malformation focus. The capillary vascular basement membrane takes place pathologyical change and the foots of astrocyte decreased or destroyed The liquid effusion from the pathologyical capillary and some vascular rupture when the blood pressure increase suddenly This is the ultrapathological mechanism of Normal Perfusion Pressure Breakthrough Syndrome during or after neurosurgical operation