Hamm R J, Jenkins L W, Lyeth B G, White-Gbadebo D M, Hayes R L
Department of Psychology, Virginia Commonwealth University and Medical College of Virginia, Richmond.
J Neurosurg. 1991 Dec;75(6):916-21. doi: 10.3171/jns.1991.75.6.0916.
Age of the patient is one of the most important predictors of outcome following human traumatic brain injury. This study employs the fluid-percussion model to investigate the effects of aging on outcome following traumatic brain injury in rats. The results revealed that there was an age-associated increase in mortality rate following both low (1.7 to 1.8 atm) and moderate (2.00 to 2.25 atm) levels of traumatic brain injury. Age-related changes in systemic physiological, neurological, and histopathological indexes of brain injury were also examined following a low level of traumatic brain injury. Traumatic brain injury produced equivalent acute hypertension and increased plasma glucose levels in both young adult and aging rats. Injury produced an acute increase in heart rate in the young adult rat group, while the heart rate decreased in the aged rats. At low levels of brain injury, no significant gross histopathological alterations were produced in either age group. Neurological outcome was assessed by measuring the duration of suppression of a number of nonpostural and postural reflexes and more complex somatomotor functions (righting, escape, head support). Except for head support, there was a significant age-related increase in the duration of the suppression of these reflexes following brain injury. These data demonstrate that aging is associated with an increased mortality rate and greater acute neurological deficits following traumatic brain injury. These data also demonstrate the usefulness of the fluid-percussion model for studying the mechanisms responsible for the age-related increase in vulnerability to brain injury.
患者年龄是人类创伤性脑损伤后预后最重要的预测指标之一。本研究采用液压冲击模型来研究衰老对大鼠创伤性脑损伤后预后的影响。结果显示，在低（1.7至1.8个大气压）和中度（2.00至2.25个大气压）创伤性脑损伤水平下，死亡率均随年龄增加而上升。在低水平创伤性脑损伤后，还检测了脑损伤的全身生理、神经和组织病理学指标的年龄相关变化。创伤性脑损伤在年轻成年大鼠和老龄大鼠中均产生了同等程度的急性高血压并使血糖水平升高。损伤使年轻成年大鼠组的心率急性增加，而老龄大鼠的心率则下降。在低水平脑损伤时，两个年龄组均未产生明显的大体组织病理学改变。通过测量多种非姿势和姿势反射以及更复杂的躯体运动功能（翻正、逃避、头部支撑）受抑制的持续时间来评估神经学预后。除头部支撑外，脑损伤后这些反射受抑制的持续时间随年龄增长显著增加。这些数据表明，衰老与创伤性脑损伤后死亡率增加和更严重的急性神经功能缺损有关。这些数据还证明了液压冲击模型在研究与年龄相关的脑损伤易感性增加的机制方面的有用性。
