Cerebral Energy Metabolism after Subarachnoid Hemorrhage.

摘要

The purpose of this study was to determine the effects of subarachnoid hemorrhage (SAH) on cerebral blood flow and cerebral oxidative metabolism. Average total hemispheric flow was measured utilizing a polarographic technique and the metabolic consumption rates of oxygen and glucose were determined from their arteriovenous differences. In the rhesus monkey the relationship between metabolism and flow after SAH was influenced by the level of intracranial pressure. In the isobaric preparation a primary depression of both aerobic and anaerobic metabolism was noted but a relative hyperemia occurred. This was followed by an ischemic phase probably associated with persistent vasoconstriction during which cerebral metabolic requirements were not met. It is concluded that after SAH the cerebral circulation is relatively unresponsive to both increased and decreased metabolic demand for nutrients, and that intracranial hypertension will provoke the onset of ischemia. It is further suggested that the hexokinase redistribution is involved in a braking system to depress glycolysis after SAH.