Marmarou A, Hochwald G, Nakamura T, Tanaka K, Weaver J, Dunbar J
Richard Roland Reynolds Neurosurgical Research Laboratories, Division of Neurosurgery, Medical College of Virginia, Richmond 23298.
Am J Physiol. 1994 Aug;267(2 Pt 2):H514-20. doi: 10.1152/ajpheart.1994.267.2.H514.
Brain edema is a major contributor to the brain swelling process and raised intracranial pressure, yet the specific pathways involved in clearance of brain edema (fluid and proteins) and their relative contribution to the resolution process remain unknown. The objective of this study was to document the temporal course of edema resolution from brain to cerebrospinal fluid (CSF) and by the brain vasculature. Radioiodinated (125I) cat serum albumin (RICSA) was infused continuously into the white matter of anesthetized adult cats for 8 h, and ventriculocisternal perfusion was used to monitor the RICSA activity in CSF at 15-min intervals and to compare with the blood taken at 15-min intervals. The RICSA that cleared from the brain in 8 h measured 29.8% of the amount infused. Of the amount of RICSA leaving the brain, we found that the CSF compartment accounted for 87.14% of the cleared RICSA volume, while only 10.96% of RICSA was found in the blood during the 8-h experiment. The amount of RICSA remaining in the brain when the animal was killed equaled 71.2 +/- 15.9% (mean +/- SD) of the RICSA infused. We conclude that vascular clearance during the acute stage of resolution is minimal and that clearance of RICSA occurs predominantly via the CSF pathways.
脑水肿是脑肿胀过程和颅内压升高的主要促成因素，然而，参与脑水肿（液体和蛋白质）清除的具体途径及其对消退过程的相对贡献仍不清楚。本研究的目的是记录从脑到脑脊液（CSF）以及通过脑血管系统的水肿消退的时间进程。将放射性碘化（125I）猫血清白蛋白（RICSA）连续注入麻醉的成年猫的白质中8小时，并采用脑室池灌注法每隔15分钟监测脑脊液中的RICSA活性，并与每隔15分钟采集的血液进行比较。8小时内从脑中清除的RICSA量为注入量的29.8%。在离开脑的RICSA量中，我们发现脑脊液部分占清除的RICSA体积的87.14%，而在8小时的实验中，血液中仅发现10.96%的RICSA。动物处死时脑中剩余的RICSA量等于注入的RICSA量的71.2±15.9%（平均值±标准差）。我们得出结论，在消退急性期，血管清除作用最小，RICSA的清除主要通过脑脊液途径进行。
