HEAD INJURY CLINICAL AND LABORATORY RESEARCH CENTER

本次颅脑损伤临床和实验室研究的主要目标 中心的目的是建立一个合理和改进治疗方法的系统 可以定义、开发和测试头部损伤患者 从科学上讲。为了实现这一目标，拟议的方案将 (1)定义生理、形态、代谢和心理社会 人类头部损伤的后遗症；(2)收集、收集和分析数据 从颅脑损伤患者中制定准确的预后；(3)明确 在良好控制的动物模型中，解剖学、生理学和 损伤对脑实质和血管的生化影响及其机制 全身功能。系统性侮辱对损伤脑的影响 将在人体和动物模型中进行研究。将进行评估 在人类治疗脑酸中毒，颅内压升高， 脑缺血和充血，神经生理状态，以及 创伤后精神抑郁。医源性低碳酸血症的作用 碱中毒患者的处理将会得到澄清。 要检验的统一假设是脑实质和它的 内源性血管系统可以承受可逆性损伤。这些组织元素 可以表现为功能障碍；然而，这种功能障碍并不意味着 不可逆转的破坏。功能障碍状态可能是暂时的，如果 内环境适合愈合，细胞可以恢复。 功能障碍可能表现为减少、过度或异常。 新陈代谢。动物重症监护病房和受控脑损伤 模型提供了实验环境。急、慢性动物 将对形态、神经和血管变化、大脑进行研究 葡萄糖利用、脑微循环、脑花生四烯酸 级联、局部脑血流和体表脑能量代谢 在受控的脑损伤之后。治疗将通过研究来检验 脑酸中毒与THAM治疗。我们试图理解 损伤后神经元丢失的基本基础，并通过干预， 逆转这一过程。

The main objective of this Head Injury Clinical and Laboratory Research Center is to establish a system whereby rational and improved therapies for patients with head injury can be defined, developed and tested scientifically. To accomplish this objective, the proposed program will (1) define the physiological, morphological, metabolic and psychosocial sequelae of head injury in man; (2) collect, assemble, and analyze data from head injured patients to formulate an accurate prognosis; (3) define in a well controlled animal model the anatomical, physiological and biochemical effects of injury on brain parenchyma and blood vessels and on systemic function. The influence of systemic insults to the injured brain will be studied both in man and in animal models. Evaluations will be made in humans of therapy for brain acidosis, elevated intracranial pressure, ischemic and hyperemic cerebral blood flows, neurophysiological status, and post traumatic mental depression. The role of iatrogenic hypocapnic alkalosis in the management of patients will be clarified. The unifying hypothesis to be tested in that the brain parenchyma and its intrinsic vasculature can sustain reversible injury. These tissue elements can be rendered dysfunctional; yet, such dysfunction does not implicate irreversible disruption. The dysfunctional state may be temporary and if the internal milieu is appropriate for healing, the cells can recover. Dysfunction may be represented by reduced, excessive or aberrant metabolism. An animal intensive care unit and a controlled brain injury model provide the experimental environment. Acute and chronic animal studies will be conducted on morphologic neural and vascular changes, brain glucose utilization, cerebral microcirculation, the brain arachidonic acid cascade, regional cerebral blood flow and surface brain energy metabolism following controlled brain injury. Therapy will be tested by studying cerebral acidosis and treatment with THAM. We seek to understand the fundamental basis of neuronal loss after injury, and, by intervention, to reverse the process.