Bullock R, Statham P, Patterson J, Wyper D, Hadley D, Teasdale E
University Department of Neurosurgery, Southern General Hospital, Glasgow, Scotland.
Acta Neurochir Suppl (Wien). 1990;51:286-8. doi: 10.1007/978-3-7091-9115-6_97.
We have tomographically mapped changes in the blood brain barrier (BBB) (99 mTc Pertechnetate) in 20 patients with acute contusions, and four with acute subdural haematomas in situ. The changes were related to regional CBF, (99 mTc HMPAO SPECT) T2 weighted MRI scans, CT abnormalities and the clinical features. Seventy-five percent of contusions were accompanied by a BBB abnormality, usually a "halo" around the lesion, which was more common in scans made after the second day. All contusions demonstrated "oedema" as a zone of "T2" signal on MRI or a zone of lucency on CT, and all were accompanied by a focal zone of low CBF on SPECT. Early contusional oedema appears to be cytotoxic but in certain cases, delayed blood brain barrier lesions develop, suggesting a vasogenic component.
我们已对20例急性脑挫伤患者以及4例急性硬膜下血肿患者的血脑屏障（99锝高锝酸盐）变化进行了断层扫描成像。这些变化与局部脑血流量（99锝六甲基丙二胺肟单光子发射计算机断层扫描）、T2加权磁共振成像扫描、CT异常以及临床特征相关。75%的脑挫伤伴有血脑屏障异常，通常在病灶周围有一个“晕环”，在第二天之后进行的扫描中更为常见。所有脑挫伤在磁共振成像上均显示为“水肿”，表现为“T2”信号区，或在CT上表现为透亮区，并且在单光子发射计算机断层扫描上均伴有局部脑血流量降低区。早期脑挫伤性水肿似乎是细胞毒性的，但在某些情况下，会出现延迟性血脑屏障损伤，提示存在血管源性成分。
