Department of Neurosurgery, West Virginia University, Morgantown, West Virginia, USA.
Neurosurgery. 2012 Mar;70(3):740-6. doi: 10.1227/NEU.0b013e318235b991.
Traumatic brain injury (TBI) remains a devastating condition for which extracranial protection traditionally has been in the form of helmets, which largely fail to protect against intracranial injury.
To determine whether the pathological outcome after traumatic brain injury can be improved via slosh mitigation by internal jugular vein (IJV) compression.
Two groups of 10 adult male Sprague-Dawley rats were subjected to impact-acceleration traumatic brain injury. One group underwent IJV compression via application of a collar before injury; the second group did not. Intracranial pressure and intraocular pressure were measured before and after IJV compression to assess collar performance. All rats were killed after a 7-day recovery period, and brainstem white matter tracts underwent fluorescent immunohistochemical processing and labeling of β-amyloid precursor protein, a marker of axonal injury. Digital imaging and statistical analyses were used to determine whether IJV compression resulted in a diminished number of injured axons.
Compression of the IJV resulted in an immediate 30% increase in intraocular and intracranial pressures. Most notably, IJV compression resulted in > 80% reduction in the number of amyloid precursor protein-positive axons as indicated by immunohistochemical analysis.
Using a standard acceleration-deceleration laboratory model of mild traumatic brain injury, we have shown successful prevention of axonal injury after IJV compression as indicated by immunohistochemical staining of amyloid precursor protein. We argue that IJV compression reduces slosh-mediated brain injury by increasing intracranial blood volume, which can be indirectly measured by intracranial and intraocular pressures.
颅脑创伤（TBI）仍然是一种毁灭性的疾病，传统的颅外保护形式是头盔，但头盔在很大程度上不能预防颅内损伤。
通过颈内静脉（IJV）压迫来减轻震荡，从而确定是否可以改善颅脑创伤后的病理结果。
两组 10 只成年雄性 Sprague-Dawley 大鼠均接受撞击-加速颅脑创伤。一组在受伤前通过佩戴项圈进行 IJV 压迫；另一组则不进行。在 IJV 压迫前后测量颅内压和眼内压，以评估项圈的性能。所有大鼠在 7 天恢复期后被处死，脑干白质束进行荧光免疫组织化学处理，并标记β-淀粉样前体蛋白，这是轴突损伤的标志物。数字成像和统计分析用于确定 IJV 压迫是否导致受损轴突数量减少。
IJV 压迫导致眼内压和颅内压立即增加 30%。最值得注意的是，免疫组织化学分析表明，IJV 压迫导致β-淀粉样前体蛋白阳性轴突数量减少了>80%。
使用标准的加速减速实验室模型轻度颅脑创伤，我们已经通过β-淀粉样前体蛋白的免疫组织化学染色显示，在 IJV 压迫后成功预防了轴突损伤。我们认为，IJV 压迫通过增加颅内血液量来减轻震荡介导的脑损伤，颅内和眼内压可以间接测量颅内血液量。
