脑顺应性Brain Compliance课件

1、Brain ComplianceBackground VTotal =Vtissue+VCSF+Vblood=constant 颅内压（Intracranial Pressure，ICP） 脑组织 80脑脊液CSF 10脑血容量CBV 10 8010 10成人的颅腔容积固定不变，为1400ml-1500mlBackground临床还可以通过颅内压监护装置，进行持续地动态观察一般以侧卧位腰椎穿刺或直接脑室穿刺测量脑脊液的静水压ICP测量：收缩期呼气时颅内压增高舒张期吸气时颅内压降低颅内压可在小范围内波动，与血压、呼吸关系密切403020100BloodCSFTissuesMassesCompen

2、satorymechanismsPVLangfilt TW et al, J Neurosurg.1964COMPLIANCE Compliance and ICP normal403020100BloodCSFTissuesMassesCompensatorymechanismsPVLangfilt TW et al, J Neurosurg.1964COMPLIANCE Compliance reducedand ICP normal颅内压的调节与代偿当颅腔总容积超过5时，颅内压开始增高，当颅腔总容积超过810时，则会产生严重的颅内压增高颅内压增高时，有一部分脑脊液被挤入脊髓蛛网膜下腔，起

3、下调颅内压的作用脑脊液的总量占颅腔总容积的10，约150mlCOMPENSATIONPrinciple buffer systemCBV150mlCSF150mlSlow / FastCOMPENSATIONCSF 吸收 slowCSF 生成CSF 体积改变fastChanges in CSF volumeCOMPENSATIONVicious circleCSF volume shift403020100BloodCSFTissuesMassesCompensatorymechanismsPVLangfilt TW et al, J Neurosurg.1964Compliance Comp

4、liance exhausted，and ICP increaseCOMPENSATIONCOMPENSATIONCOMPENSATIONAnatomical Correlates Vor ICP CompensationICP WaveICP WaveActa Neurochir (Wien) (2004) 146: 131141ICP WaveICP and CVRPVI=pressure volume index calculationICP=Pbrain+Pblood vessels+PCSFbloodCSFNormalCompensatedDecompensatedICP7-15mmHgICP20-25mmHgICP 30mmHgmassBrain tissuemassAnatomical Correlates Vor ICP CompensationPVI=