Experimental nerve thermal injury.

Thermal injury to rat sciatic nerve was produced by local heating (47 and 58 degrees C) and studied physiologically and morphologically. Unmyelinated nerve fibres showed a greater direct vulnerability to hyperthermia; first manifest as a reversible conduction block of C fibre action potentials and at higher temperatures by immediate and selective axonal degeneration. By contrast, lower grade nerve thermal injury resulted in delayed, selective loss of myelinated fibres. Evidence from this study suggests that this is secondary to a heat-induced angiopathy, immediately and diffusely manifest in the vasa nervorum and giving rise to a progressive and ultimately severe reduction in nerve blood flow. The relative sparing of unmyelinated fibres is likely to be a result of their greater resistance to ischaemia. The pathological vulnerability of unmyelinated fibres to thermal injury, coupled with the susceptibility of large myelinated nerve fibres to secondary ischaemia, largely resolves previous contradictions in the literature.