Chen Yun, Huang Wei
Tripler Army Medical Center, Honolulu, HI, USA.
Brain Inj. 2011;25(7-8):641-50. doi: 10.3109/02699052.2011.580313. Epub 2011 May 23.
A volumetric blood surge (rapid physical movement/displacement of blood) is hypothesized to cause the non-impact, mild TBI and battlefield PTSD induced by a blast over-pressure wave.
Systematic review of the literature.
Articles relating to the fields of blast injury, brain injury and relevant disorders were searched between the years 1968-2010 for keywords such as 'brain injury', 'post-traumatic stress disorder' and 'blast pressure wave'. Articles found through journal and Internet databases were cross-referenced.
The blood surge, which is driven by elevated overall pressure in the ventral body cavity after exposure of the torso to blast wave, may move through blood vessels to the low-pressure cranial cavity from the high-pressure ventral body cavity. It dramatically increases cerebral perfusion pressure and causes damage to both tiny cerebral blood vessels and the BBB.
Three factors may be critical to the induction of blast-induced brain injuries: (1) the difference in pressure between the ventral body cavity and cranial cavity; (2) blood that acts as a transmission medium to propagate a pressure wave to the brain; and (3) the vulnerability of cerebral blood vessels and the BBB to a sudden fluctuation in perfusion pressure.
假设大量血液涌动（血液的快速物理移动/位移）会导致由爆炸超压波引起的非撞击性轻度创伤性脑损伤和战场创伤后应激障碍。
对文献进行系统综述。
在1968年至2010年间，搜索与爆炸伤、脑损伤及相关疾病领域相关的文章，查找“脑损伤”、“创伤后应激障碍”和“爆炸压力波”等关键词。通过期刊和互联网数据库找到的文章进行相互参照。
在躯干暴露于爆炸波后，由腹侧体腔中升高的总压力驱动的血液涌动，可能从高压的腹侧体腔通过血管流向低压的颅腔。这会显著增加脑灌注压，并对微小的脑血管和血脑屏障造成损害。
对于爆炸所致脑损伤的诱发，三个因素可能至关重要：（1）腹侧体腔与颅腔之间的压力差；（2）作为将压力波传播至大脑的传输介质的血液；（3）脑血管和血脑屏障对灌注压突然波动的易损性。
