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猫侧方和中央模式流体冲击伤所致水肿的比较研究。

Comparative studies of edema produced by fluid percussion injury with lateral and central modes of injury in cats.

作者信息

Marmarou A, Shima K

机构信息

Richard Roland Reynolds Neurosurgical Research Laboratories, Medical College of Virginia, Richmond 23298.

出版信息

Adv Neurol. 1990;52:233-6.

PMID:2396517
Abstract

Earlier studies by our laboratories indicated that severe fluid percussion injury in cats results in the development of significant brain edema. In this study we measured the spatial distribution of edema developed after both central and lateral modes of impact with the objective of determining the degree to which the edema volume may contribute to ICP elevation and neurologic deterioration. All animals developed a marked increase in tissue water, particularly in the brainstem. In laterally injured cats, the increase in brainstem water equaled the edema produced supratentorially. Adding the increase of brainstem edema and the edema volume of the supratentorial compartment, we found an average water increase of 1.125 cc in survivors and 2.492 cc in nonsurvivors. This represents a significant volume increase when it is considered that the average PVI of the normal cat is approximately 0.9 cc (6). However, we observed that the PVI was reduced soon after injury and at a time when it has been reported that water content was near normal levels (7). Taking these studies in concert, we believe that the early reduction in PVI is most probably due to vascular swelling. The developing edema further contributes to reductions in PVI, thus setting the stage for elevated ICP and the tissue impaction observed in nonsurvivors.

摘要

我们实验室早期的研究表明,猫遭受严重的流体冲击伤会导致明显的脑水肿。在本研究中,我们测量了中枢和侧方冲击后水肿的空间分布,目的是确定水肿体积可能导致颅内压升高和神经功能恶化的程度。所有动物的组织含水量均显著增加,尤其是在脑干。在侧方受伤的猫中,脑干含水量的增加与幕上产生的水肿相当。将脑干水肿的增加量与幕上腔室的水肿体积相加,我们发现幸存者的平均含水量增加了1.125立方厘米,非幸存者增加了2.492立方厘米。考虑到正常猫的平均颅内容积约为0.9立方厘米(6),这代表了显著的体积增加。然而,我们观察到受伤后不久颅内容积就减少了,而据报道此时含水量接近正常水平(7)。综合这些研究,我们认为早期颅内容积的减少很可能是由于血管肿胀。逐渐发展的水肿进一步导致颅内容积减少,从而为颅内压升高和非幸存者中观察到的组织受压奠定了基础。

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