CLINICAL PATHOPHYSIOLOGY OF ACUTE BRAIN INJURY

急性脑损伤的临床病理生理学

• 批准号: 2714628
• 负责人: WILLIAM J POWERS
• 金额: $ 77.5万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1997
• 资助国家: 美国
• 起止时间: 1997-09-01 至 2002-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2714628
• 关键词: brain injury; cerebral hemorrhage; cerebral ischemia /hypoxia; pathologic process

The overall goal of this Program project is to investigate ischemia as a secondary mechanism of tissue damage in the early period following acute brain injury. Secondary mechanisms, occurring in a delayed manner, provide the best opportunity for successful therapeutic intervention. A better understanding of the pathophysiology of secondary tissue damage following acute brain injury is important if improvements are to be made in current therapy. We will investigate two types of acute brain injury head trauma and intracerebral hemorrhage. In project 1, Drs. Michael Diringer and Robert Grubb will use positron emission tomography (PET) to investigate the occurrence and duration of focal cerebral ischemia in acute traumatic brain injury in project 2, Drs. Michael Diringer and Robert Grubb will use PET to determine the effect of hyperventilation on regional cerebral blood flow and brain oxygenation in acute traumatic brain injury. In project 3, Drs. William Powers and Michael Diringer will use PET to investigate the occurrence and duration of focal cerebral ischemia in acute intracerebral hemorrhage. In project 4, Drs. William Powers and Michael Deringer will use PET to determine th effect of pharmacologic reduction of systemic arterial pressure on regional cerebral blood flow and brain oxygenation in acute intracerebral hemorrhage. The PET Facilities Core directed by Dr Powers will coordinate those aspects of the initial acquisition, reconstruction and archiving of the PET, clinical and CT data. The PET Image Analysis Core directed by Dr. Tom Videen will implement and validate improved methods for analysis of PET images. This Program Project draws on a combination of facilities and expertise at Washington University that is unique. It combines state-of-the-artPET equipment for quantitative neuroimaging located in an intensive car unity, expertise in the care of critically ill neurological patients and many years experience in studying cerebral blood flow and metabolism. This research will provide fundamentally important pathophysiologic information about the role of ischemia in producing secondary tissue damage in patients with acute brain injury due to head trauma and intracerebral hemorrhage. This information is will provide new understanding of the pathophysiology of these conditions which will be important in guiding future research toward the most fruitful approaches for ameliorating the devastating impact of acute brain injury. The results of these studies will have immediate and direct applicability to the thousands of patients each year who suffer from these diseases.

该计划项目的总体目标是调查缺血作为 急性发作后早期组织损伤的次要机制 脑损伤。 次要机制，以延迟的方式发生， 为成功的治疗干预提供最佳机会。 一个 更好地了解继发性组织损伤的病理生理学 如果要做出改善，急性脑损伤后的情况很重要 在目前的治疗中。 我们将研究两种类型的急性脑损伤 头部外伤和脑出血。 在项目 1 中，Drs。迈克尔 Diringer 和 Robert Grubb 将使用正电子发射断层扫描 (PET) 调查局灶性脑缺血的发生情况和持续时间 项目 2 中的急性创伤性脑损伤，博士。迈克尔·迪林格和 罗伯特·格鲁布 (Robert Grubb) 将使用 PET 来确定过度换气对患者的影响 急性创伤时局部脑血流量和脑氧合 脑损伤。 在项目 3 中，博士。威廉·鲍尔斯和迈克尔·迪林格将 利用PET研究局灶性脑病的发生及持续时间 急性脑出血引起的缺血。 在项目 4 中，博士。威廉 Powers 和 Michael Deringer 将使用 PET 来确定 药物降低局部脑全身动脉压 急性脑出血时的血流和脑氧合。 这 由 Powers 博士指导的 PET 设施核心将协调以下方面： PET、临床的初始采集、重建和归档 和CT数据。 Tom Videen 博士指导的 PET 图像分析核心将 实施并验证改进的 PET 图像分析方法。 这 计划项目结合了以下机构的设施和专业知识 华盛顿大学这一点是独一无二的。它结合了最先进的 PET 位于密集汽车单元中的定量神经成像设备， 在危重神经病患者的护理方面拥有丰富的专业知识 多年研究脑血流和代谢的经验。 这 研究将提供根本上重要的病理生理信息 关于缺血在产生继发性组织损伤中的作用 因头部外伤、脑内出血等原因导致急性脑损伤的患者 出血。 这些信息将提供对 这些病症的病理生理学对于指导非常重要 未来的研究旨在寻找最有效的方法来改善 急性脑损伤的毁灭性影响。 这些研究的结果 将立即直接适用于成千上万的患者 每年都有人患有这些疾病。