The Relative Contribution of Edema and Hemorrhage to Raised Intrathecal Pressure after Traumatic Spinal Cord Injury
The Relative Contribution of Edema and Hemorrhage to Raised Intrathecal Pressure after Traumatic Spinal Cord Injury
复制标题
DOI：
10.1089/neu.2014.3543
复制
发表时间：
2015-03-15
影响因子：
4.2
通讯作者：
Vink, Robert
中科院分区：
文献类型：
--
作者：
Leonard, Anna V.;Thornton, Emma;Vink, Robert
创伤性脊髓损伤（SCI）后鞘内压（ITP）升高是损伤发展的一个至关重要的方面，可能导致显著更大的组织损伤和更差的功能结局。升高的ITP是由血液和/或水的积聚（水肿）引起的，虽然它们在创伤性SCI后的发生已经得到了很好的证实，但这两个过程对SCI后ITP发展的相对贡献尚未确定。因此，本研究调查了创伤性SCI后ITP升高与出血和水肿发展的时间关系。在新西兰白色兔中，在T10时诱导闭合球囊压迫损伤。此后，从SCI后5小时至1周，评估动物的脊髓含水量（水肿）、ITP、病变和出血量以及白蛋白免疫反应性。损伤后5小时ITP的早期增加与血容量的显著增加相关。然而，ITP在SCI后3天达到最大，此时水肿显著增加，持续1周。我们得出结论，创伤性SCI后ITP的升高最初是由出血体积增加引起的，而水肿在伤后3天成为ITP的主要驱动因素。
Raised intrathecal pressure (ITP) after traumatic spinal cord injury (SCI) is a critically important aspect of injury development that may result in significantly greater tissue damage and worsened functional outcome. Raised ITP is caused by the accumulation of blood and/or water (edema), and while their occurrence after traumatic SCI has been well established, the relative contribution of both processes to the development of ITP after SCI has not yet been determined. Accordingly, the current study investigates the temporal profile of raised ITP after traumatic SCI in relation to both hemorrhage and edema development. A closed balloon compression injury was induced at T10 in New Zealand White rabbits. Animals were thereafter assessed for spinal water content (edema), ITP, lesion and hemorrhage volume, and albumin immunoreactivity from 5 h to 1 week post-SCI. Early increases in ITP at 5 h post-injury were associated with significant increases in blood volume. ITP, however, was maximal at 3 days post-SCI, at which time there was an associated significant increase in edema that persisted for 1 week. We conclude that raised ITP after traumatic SCI is initially driven by volumetric increases in hemorrhage, while edema becomes the primary driver of ITP at 3 days post-injury.