[Cerebral microcirculation during increased intracranial pressure--assessment with reflectance photometry]

The cerebral microcirculation under increased intracranial pressure was evaluated by using reflectance photometric method. The values of tissue hemoglobin (IHb) and its oxygen saturation (ISO2) detected by this method were evaluated in cat brain tissue. The correlation between IHb and content of cortical hemoglobin subunits in vitro was high. High correlation between ISO2 and blood oxygen saturation in superior sagittal sinus was also noted in hypoxic hypoxia. Thus, the reflectance photometric method was revealed to be applicable for evaluation of regional hemoglobin content and oxygen saturation. Using this method the cerebral microcirculation was studied in an increased intracranial pressure model produced by injection of artificial CSF into the cisterna magna in cats. Regional cortical cerebral blood flow (CBF) was measured simultaneously by thermal diffusion method. During decrease of perfusion pressure down to 40 mmHg with preservation of CBF, compensatory increase of IHb was not observed, but IHb rather gradually decreased. The decrease of IHb would be due collapse of capacitance vessels by increased intracranial pressure. Cerebral ISO2 was stable as well as CBF. Less than 40 mmHg of perfusion pressure, ISO2 started to decrease in association with CBF and IHb. Since ISO2 seems to be closely related to the tissue oxygen extraction the change of ISO2 reflect the CBF and tissue cerebral oxygen metabolism. Present study suggest the evaluations of IHb and ISO2 were an useful monitoring indexes in various cerebral disorders.