Monson Kenneth L, Converse Matthew I, Manley Geoffrey T
Department of Mechanical Engineering, University of Utah, USA; Department of Bioengineering, University of Utah, USA.
Department of Mechanical Engineering, University of Utah, USA.
Clin Biomech (Bristol). 2019 Apr;64:98-113. doi: 10.1016/j.clinbiomech.2018.02.011. Epub 2018 Feb 19.
Traumatic brain injury is a devastating cause of death and disability. Although injury of brain tissue is of primary interest in head trauma, nearly all significant cases include damage of the cerebral blood vessels. Because vessels are critical to the maintenance of the healthy brain, any injury or dysfunction of the vasculature puts neural tissue at risk. It is well known that these vessels commonly tear and bleed as an immediate consequence of traumatic brain injury. It follows that other vessels experience deformations that are significant though not severe enough to produce bleeding. Recent data show that such subfailure deformations damage the microstructure of the cerebral vessels, altering both their structure and function. Little is known about the prognosis of these injured vessels and their potential contribution to disease development. The objective of this review is to describe the current state of knowledge on the mechanics of cerebral vessels during head trauma and how they respond to the applied loads. Further research on these topics will clarify the role of blood vessels in the progression of traumatic brain injury and is expected to provide insight into improved strategies for treatment of the disease.
创伤性脑损伤是导致死亡和残疾的一个毁灭性原因。虽然脑组织损伤是头部创伤中主要关注的问题，但几乎所有严重病例都包括脑血管损伤。由于血管对于维持健康的大脑至关重要，脉管系统的任何损伤或功能障碍都会使神经组织面临风险。众所周知，这些血管通常会因创伤性脑损伤而立即撕裂和出血。因此，其他血管会经历显著的变形，虽然这些变形并不严重到足以导致出血。最近的数据表明，这种未达到失效程度的变形会损害脑血管的微观结构，改变其结构和功能。关于这些受损血管的预后及其对疾病发展的潜在影响，人们知之甚少。本综述的目的是描述头部创伤期间脑血管力学的当前知识状态，以及它们如何响应所施加的载荷。对这些主题的进一步研究将阐明血管在创伤性脑损伤进展中的作用，并有望为改进该疾病的治疗策略提供见解。
