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首页> 外文期刊>Journal of neurology >Trigeminocardiac reflex. A clinical phenomenon or a new physiological entity?
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Trigeminocardiac reflex. A clinical phenomenon or a new physiological entity?

机译：三角肌反射。是临床现象还是新的生理实体？

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摘要

The trigemino-cardiac reflex (TCR) is defined as the sudden onset of parasympathetic dysrhythmia, sympathetic hypotension, apnea or gastric hypermotility during stimulation of any of the sensory branches of the trigeminal nerve. The sensory nerve endings of the trigeminal nerve send neuronal signals via the Gasserian ganglion to the sensory nucleus of the trigeminal nerve, forming the afferent pathway of the reflex arc. This afferent pathway continues along the short internuncial nerve fibers in the reticular formatio to connect with the efferent pathway in the motor nucleus of the vagus nerve. Clinically, the trigemino-cardiac reflex has been reported to occur during craniofacial surgery, balloon-compression rhizolysis of the trigeminal ganglion, and tumor resection in the cerebellopontine angle. Apart from the few clinical reports, the physiological function of this brainstem-reflex has not yet been fully explored. From experimental findings, it may be suggested that the trigemino-cardiac reflex represents an expression of a central neurogenic reflex leading to rapid cerebrovascular vasodilatation generated from excitation of oxygen-sensitive neurons in the rostral ventrolateral medulla oblongata. By this physiological response, the adjustments of the systemic and cerebral circulations are initiated to divert blood to the brain or to increase blood flow within it. As it is generally accepted that the diving reflex and ischemic tolerance appear to involve at least partially similar physiological mechanisms, the existence of such endogenous neuroprotective strategies may extend the actually known clinical appearance of the TCR and include the prevention of other potentially brain injury states as well. This may be in line with the suggestion that the TCR is a physiological, but not a pathophysiological entity.
机译：三叉神经心脏反射（TCR）定义为在刺激三叉神经的任何感觉分支过程中副交感神经节律失常，交感神经性低血压，呼吸暂停或胃动力亢进突然发作。三叉神经的感觉神经末梢通过Gasserian神经节向三叉神经的感觉神经核发送神经元信号，形成反射弧的传入路径。该传入通路沿着网状格式中的短内神经纤维继续延伸，以与迷走神经运动核内的传出通路相连。临床上，据报道三叉神经心脏反射发生在颅面外科手术，三叉神经节的球囊压缩根除术和小脑桥脑角肿瘤切除术期间。除少数临床报道外，这种脑干反射的生理功能尚未得到充分研究。从实验结果可以暗示，三叉神经-心脏反射代表中枢神经源性反射的表达，该中枢神经源性反射导致长形的延髓腹侧延髓的氧敏感性神经元的激发产生快速的脑血管血管舒张。通过这种生理反应，开始进行全身和大脑循环的调节，以将血液转移到大脑或增加大脑中的血流量。众所周知，潜水反射和缺血耐受似乎至少部分涉及相似的生理机制，因此这种内源性神经保护策略的存在可能会扩展TCR的实际临床表现，并包括预防其他潜在的脑损伤状态，例如好。这可能与TCR是生理实体而不是病理生理实体的建议相符。

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