Wajima Daisuke, Sato Fumiya, Kawamura Kenya, Sugiura Keisuke, Nakagawa Ichiro, Motoyama Yasushi, Park Young-Soo, Nakase Hiroyuki
Department of Neurosurgery, Nara Medical University, Japan.
Department of Neurosurgery, Nara Medical University, Japan.
Brain Res. 2017 Sep 1;1670:165-172. doi: 10.1016/j.brainres.2017.06.017. Epub 2017 Jun 21.
Acute subdural hematoma (ASDH) is a frequent complication of severe head injury, whose secondary ischemic lesions are often responsible for the severity of the disease. We focused on the differences of secondary ischemic lesions caused by the components, 0.4ml venous- or arterial-blood, or saline, infused in the subdural space, evaluating the differences in vivo model, using rats. The saline infused rats are made for elderly atrophic brain with subdural effusion (SDE) model. Our data showed that subdural blood, both venous- and arterial-blood, aggravate brain edema and lesion development more than SDE. This study is the first study, in which different fluids in rats' subdural space, ASDH or SDE are compared with the extension of early and delayed brain damage by measuring brain edema and histological lesion volume. Blood constituents started to affect the degree of ischemia underneath the subdural hemorrhage, leading to more pronounced breakdown of the blood-brain barrier and brain damage. This indicates that further strategies to treat blood-dependent effects more efficiently are in view for patients with ASDH.
急性硬膜下血肿(ASDH)是重度颅脑损伤的常见并发症,其继发性缺血性病变往往决定了疾病的严重程度。我们重点研究了在大鼠硬膜下间隙注入0.4毫升静脉血、动脉血或生理盐水后所导致的继发性缺血性病变的差异,并通过体内模型进行评估。注入生理盐水的大鼠用于建立老年萎缩性脑伴硬膜下积液(SDE)模型。我们的数据显示,硬膜下血,包括静脉血和动脉血,比SDE更易加重脑水肿和病变发展。本研究首次通过测量脑水肿和组织学病变体积,比较了大鼠硬膜下间隙注入不同液体(ASDH或SDE)后早期和延迟性脑损伤的扩展情况。血液成分开始影响硬膜下出血下方的缺血程度,导致血脑屏障更明显的破坏和脑损伤。这表明,对于ASDH患者,需要进一步制定更有效的策略来治疗与血液相关的影响。