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Hirndurchblutung und Hirnblutvolumen bei kommunizierendem Hydrocephalus

Cerebral blood flow and cerebral blood volume in communicating hydrocephalus

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Summary

Regional cerebral blood flow (rCBF) and regional cerebral blood volume (rCBV) were estimated in patients with communicating hydrocephalus, arteriosclerotic and presenile dementia. In all groups ischemic patterns were detected which did not allow any differential diagnostic separation between the patients. In some patients with communicating hydrocephalus reduction of cerebrospinal fluid pressure by lumbar puncture or ventriculoperipheral shunt respectively resulted in increase of rCBF and rCBV. This was not achieved in the other patients with dementia. Predominantly areas with ischemic flow values gained profit from reduction of CSF pressure. This was interpreted as a sign of regional damage to the autoregulation.

Zusammenfassung

Bei Patienten mit kommunizierendem Hydrocephalus und bei Patienten mit arteriosklerotischer bzw. präseniler Demenz wurden die regionale Hirndurchblutung und das regionale Hirnblutvolumen gemessen. In beiden Gruppen fanden sich hypämische Areale, deren Anordnung nicht geeignet ist, eine differentialdiagnostische Abklärung zu ermöglichen. Während bei Patienten mit kommunizierendem Hydrocephalus eine drucksenkende lumbale Liquordrainage in vielen Fällen zum Anstieg der Hirndurchblutung und des Hirnblutvolumens führte, gelang dieses bei den anderen Fällen nicht. Bei Patienten mit kommunizierendem Hydrocephalus führte ein ventriculo-peripherer liquorableitender Shunt häufig zum Anstieg von Durchblutung und Blutvolumen, wobei vor allem hypämische Areale eine Durchblutungssteigerung erfuhren. Der Tatbestand, daß eine geringfügige Liquordrucksenkung eine Durchblutungsänderung veranlaßt, weist auf eine gestörte Autoregulation hin.

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  1. Neurologische Universitätsklinik, Voßstraße 2, D-6900, Heidelberg, Bundesrepublik Deutschland

    A. Hartmann & E. Alberti

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  1. A. Hartmann
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  2. E. Alberti
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Hartmann, A., Alberti, E. Hirndurchblutung und Hirnblutvolumen bei kommunizierendem Hydrocephalus. Arch. Psychiat. Nervenkr. 225, 291–306 (1978). https://doi.org/10.1007/BF00343301

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  • DOI: https://doi.org/10.1007/BF00343301

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