von Baumgarten Louisa, Trabold Raimund, Thal Serge, Back Tobias, Plesnila Nikolaus
Institute for Surgical Research, University of Munich Medical Center-Grosshadern, Munich, Germany.
J Cereb Blood Flow Metab. 2008 Jul;28(7):1353-60. doi: 10.1038/jcbfm.2008.30. Epub 2008 Apr 16.
In recent years, several studies have unequivocally shown the occurrence of cortical spreading depressions (CSDs) after stroke and traumatic brain injury (TBI) in humans. The fundamental question, however, is whether CSDs cause or result from secondary brain damage. The aim of the current study was, therefore, to investigate the role of CSDs for secondary brain damage in an experimental model of TBI. C57/BL6 mice were traumatized by controlled cortical impact. Immediately after trauma, each animal showed one heterogeneous direct current (DC) potential shift accompanied by a profound depression of electroencephalogram (EEG) amplitude, and a temporary decrease of ipsi- and contralateral regional cerebral blood flow (rCBF) suggesting bilateral CSDs. Within the next 3 h after TBI, CSDs occurred at a low frequency (0.38 CSD/h per animal, n=7) and were accompanied by rCBF changes confined to the ipsilateral hemisphere. No significant relationship between the number of SDs and lesion size or intracranial pressure (ICP) could be detected. Even increasing the number of posttraumatic CSDs by application of KCl by more than six times did not increase ICP or contusion volume. We therefore conclude that CSDs may not contribute to posttraumatic secondary brain damage in the normally perfused and oxygenated brain.
近年来,多项研究明确表明,人类中风和创伤性脑损伤(TBI)后会出现皮质扩散性抑制(CSD)。然而,根本问题在于CSD是继发脑损伤的原因还是结果。因此,本研究的目的是在TBI实验模型中研究CSD在继发脑损伤中的作用。通过控制性皮质撞击对C57/BL6小鼠造成创伤。创伤后立即,每只动物均出现一次异质性直流(DC)电位偏移,伴有脑电图(EEG)振幅的显著降低,以及同侧和对侧局部脑血流(rCBF)的暂时减少,提示双侧CSD。在TBI后的接下来3小时内,CSD以低频率发生(每只动物0.38次CSD/小时,n = 7),并伴有仅限于同侧半球的rCBF变化。未检测到SDs数量与损伤大小或颅内压(ICP)之间存在显著关系。即使通过应用氯化钾使创伤后CSD的数量增加超过六倍,也不会增加ICP或挫伤体积。因此,我们得出结论,在正常灌注和氧合的大脑中,CSD可能不会导致创伤后继发脑损伤。
J Cereb Blood Flow Metab. 2008-7
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