CLINICAL PATHOPHYSIOLOGY OF ACUTE BRAIN INJURY

该计划项目的总体目标是将缺血作为一种 急性心肌梗死早期组织损伤的继发性机制 脑部受伤。二级机制，以延迟的方式发生， 为成功的治疗干预提供最好的机会。一个 更好地了解继发性组织损伤的病理生理学 如果要进行改善，急性脑损伤后的情况是重要的 在目前的治疗中。我们将调查两种类型的急性脑损伤 头部创伤和脑出血。在项目1中，迈克尔博士 迪林格和罗伯特·格拉布将使用正电子发射断层扫描(PET)来 探讨大鼠局灶性脑缺血的发生及持续时间 项目2中的急性创伤性脑损伤，Michael Diringer博士和 罗伯特·格拉布将使用正电子发射计算机断层扫描来确定过度换气对心脏的影响 急性创伤患者局部脑血流量与脑氧合的关系 脑部受伤。在项目3中，威廉·鲍尔斯博士和迈克尔·迪林格将 应用正电子发射计算机断层扫描研究局灶性脑出血的发生及病程 急性脑出血时的脑缺血。在项目4中，威廉博士 鲍尔斯和迈克尔·德林格将使用正电子发射计算机断层扫描来确定 药物降低体动脉压对局部脑的影响 急性脑出血患者的脑血流和脑氧合。这个 由鲍尔斯博士指导的宠物设施核心将协调以下方面 临床正电子发射计算机断层扫描的初始采集、重建和存档 和CT数据。汤姆·维登博士指导的PET图像分析核心 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方面的设施和专业知识 华盛顿大学是独一无二的。它结合了最先进的PET 定量神经成像设备位于密集的汽车单元中， 在护理危重神经科病人方面的专业知识 多年脑血流和新陈代谢研究经验。这 研究将提供根本重要的病理生理学信息 关于脑缺血在继发性组织损伤中的作用 颅脑损伤合并急性颅脑损伤的临床分析 大出血。这一信息将为我们提供对 这些情况的病理生理学，这将是指导 未来研究如何采取最有成效的方法来改善 急性脑损伤的毁灭性影响。这些研究的结果 将直接适用于数以千计的患者 每年遭受这些疾病折磨的人。

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.