Hemodynamic Depression and Microthrombosis Formation in the Peripheral Areas of Cerebral Contusion

脑挫裂伤周围区域的血流动力学抑制和微血栓形成

• 批准号: 07671547
• 负责人: YAMAMOTO Takamitsu
• 金额: $ 1.41万
• 依托单位: Nihon University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1995
• 资助国家: 日本
• 起止时间: 1995 至 1997
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-07671547/
• 关键词: trauma; brain injury; cerebral contusion; cerebral blood flow; microthrombosis; brain edema; tissue osmolality; rat; 血管内凝固; 血小板

Cerebral contusious sometimes cause progressive or delayd deterioration of neurological symptoms, which may result from secondary injury processes of the traumatized brain. It is important to elucidate pathophysiology underlying secondary brain damages, since one principal goal of treatments for traumatic brain injury is to prevent such secondary damages following the injury. In the present syudy, in order to elucidate the mechanisms of contusion-induced secondary cell injury processes, we investigated hemodynamic changes in cerebral contusion, and effects of anti-thrombosis and anti-coagulate drugs were tested in a rat cortical contusion induced by a controlled cortical impact device. Results (1)Histological examinations revealed that the initial histopathological finding in the peripheral area of contusion was microthrombosis formation, followed by brain edema and necrosis formation. These changes progressively extended to peripheral area surrounding the contusion. (2)In the central … More area of contusion, cerebral blood flow (CBF) was decreased to the ischemic level within 5-15 min after the injury induction. In the peripheral area, CBF was decreased to 20% of the beseline, returned to 40-60% level, and then decreased again to the ischemic level without any recovery. (3)A inhibitor of platelet activating factor (PAF), etizolam, attenuated the contusional necrosis formation as well as decreasing CBF in the peripheral but not in the central area of contusion. (4)The tissue osmolality of contusion increased immediately following the injury, and the tissue water content increased thereafter. (5)The concentration of the tissue cations (total amount of [Na^+]+[K^+] in the contusion did not show any significant changes, indicating inorganic ions do not mainly participate in the tissue osmolality increase. Discussion The results of the present study indicate that the microthrombosis formation in the peripheral areas of contusion may contribute to the secondary cell injury processes in cerebral contusion. Anti-thrombosis with a PAF antagonist has a therapeutic potential to attenuate the lschemic btain damage and subsequent edema formation following the contusion. The progressive increase in tissue osmolality is another cause of contusion-induced edema formation. Increases in metabolic intermediate osmoles and/or idiogenic osmoles resulting from the catabolic degradation of intracellular high molecular substances, e.g.phospholipids in cell membrane, may play a major role for the formation of osmotic potential and a resultant brain edema in the cerebral contusion. Less

脑部欺骗有时会导致神经系统症状的进行性或延迟恶化，这可能是由于受创伤性大脑的继发性损伤过程所致。重要的是要阐明继发性脑损伤的病理生理学，因为治疗颅脑损伤的主要目标是防止受伤后这种次要损害。在本建议中，为了阐明挫伤诱导的继发性细胞损伤过程的机制，我们研究了脑挫伤的血液动力学变化，并在由受控的皮质影响装置引起的大鼠皮质inosistial中测试了抗thrombosis和抗凝药物的作用。结果（1）组织学检查表明，挫伤周围区域中最初的组织病理学发现是微型骨骼形成，其次是脑水肿和坏死形成。这些变化逐渐扩展到挫伤周围周围的外围区域。 （2）在中央…更多的挫伤区域，脑血流（CBF）在损伤诱导后5-15分钟内降低至缺血水平。在外围区域，CBF降至贝线的20％，恢复到40-60％的水平，然后再次降低至缺血水平，而没有任何恢复。 （3）血小板激活因子（PAF）的抑制剂，Etizolam，衰减了污染性坏死的形成，并减少周围的CBF，但在挫折的中心区域中却没有。 （4）损伤后挫伤的组织渗透压立即增加，然后组织含水量增加。 (5)The concentration of the tissue cations (total amount of [Na^+]+[K^+] in the contusion did not show any significant changes, indicating inorganic ions do not mainly participate in the tissue osmolality increase. Discussion The results of the present study indicate that the microthrombosis formation in the peripheral areas of contusion may contribute to the secondary cell injury processes in cerebral contusion. Anti-thrombosis with a PAF拮抗剂具有抑制lschmicy btain损伤的治疗潜力，并在挫伤后逐渐形成的水肿。膜在渗透潜力的形成和大脑挫伤中起主要作用

项目成果

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Yamamoto T，Katayama Y，Tsubokawa T，等人：“中枢性中风后疼痛的药理学分类：与慢性运动皮层刺激疗法的结果比较”疼痛。

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Takamitsu Yamamoto、Yoichi Katayama等：“无骨损伤的颈椎损伤急性期的治疗方法：从杀伤端皮质脊髓诱发电位转变的角度检查治疗方法”日本截瘫医学会杂志。 9（1）。24-25（1996）

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Kurihara J、Yamamoto T、Katayama Y 等人：“受控冲击装置引起的实验性脊髓损伤：电生理学和组织学研究”神经创伤研究进展。