Intravascular coagulation: a major secondary insult in nonfatal traumatic brain injury
Intravascular coagulation: a major secondary insult in nonfatal traumatic brain injury
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DOI：
10.3171/jns.2002.97.6.1373
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发表时间：
2002-12-01
影响因子：
4.1
通讯作者：
Smith, DH
中科院分区：
文献类型：
--
作者：
Stein, SC;Chen, XH;Smith, DH
物体。本研究的目的是确定脑血管内凝血(IC)合并创伤性脑损伤(TBI)的频率。作者还调查了不同机制、不同病程、不同严重程度的颅脑损伤以及不同物种中IC的发生率。组织来自人脑挫伤的手术标本，来自侧向流体冲击损伤的大鼠，以及来自头部旋转加速损伤的猪。抗凝血酶III免疫组织化学荧光染色检测脑血管内微血栓。所有标本均可见丰富的IC，微血栓形成于大小不等的小动脉和小静脉，大小在10~600微米之间。虽然在局灶性损伤和较严重的损伤中更明显，但在轻度和弥漫性损伤中也可以观察到相当大的IC。作者发现，凝血障碍的严重程度与IC的密度有很强的相关性。这些结果有力地支持了IC是对脑外伤的普遍反应和一种重要的继发性脑损伤的观点。
Object. The goal of this study was to determine the frequency with which cerebral intravascular coagulation (IC) complicates traumatic brain injury (TBI). The authors also investigated the incidence of IC in relation to varying mechanisms, time courses, and severities of TBI and in different species.Methods. Tissue was sampled from surgical specimens of human cerebral contusions, from rats with lateral fluid-percussion injuries, and from pigs with head rotational acceleration injuries. Immunohistochemical fluorescent staining for antithrombin III was performed to detect cerebral intravascular microthrombi. Abundant IC was found in all specimens, and microthrombi had formed in arterioles and venules of all sizes, ranging from 10 to 600 mum. Although it was more pronounced in focal lesions and more severe injuries, considerable IC was also observed in mild and diffuse injuries. The authors found a strong association between the severity of coagulopathy and the density of IC.Conclusions. These results strongly support the contention that IC is a universal response to TBI and an important secondary cerebral insult.