HEAD INJURY CLINICAL RESEARCH CENTER

本研究的主要目的是确定相对 成人机械性和缺氧性脑损伤的发生率和意义， 严重头部损伤的儿童和加速性头部损伤模型中， 恒河猴，使用神经学检查作为标准;测量 颅内压、脑血流量和代谢;平均诱发 潜力;和神经病理学。 因为我们相信缺氧和缺血 缺氧是头部受伤常见并发症，我们亦正研究 动物的事件顺序，导致缺氧性脑损伤的关键 脑灌注压和全身氧合水平，基于两个 假设：1）脑损伤不依赖于高能量失败 磷酸盐代谢; 2）持续或不可逆缺氧的薄弱环节 细胞的损伤是细胞内离子平衡的恢复失败 膜的 在人类研究中，利用了 用于病变解剖定位的非侵入性方法（CT扫描）， 局部脑血流量评估（Xe 133吸入法）。 两 这些新技术允许在疾病过程中进行连续观察 和后续行动，这可能与结果相关。 当用于 结合脑代谢率和颅内压的测量， 急性期的压力、有关各种药物有效性的信息 治疗（例如，甘露醇和换气过度）。 平行 病理生理学研究正在猴子身上进行， 可以产生和更好地定义分级严重程度的损伤， 可以测试各种实验疗法。

The principal objectives of this research are to determine the relative incidence and significance of mechanical and hypoxic brain damage in adults and children with severe head injuries and in a model of acceleration head injury in the rhesus monkey, using as criteria the neurological examination; measurements of intracranial pressure, cerebral blood flow, and metabolism; averaged evoked potentials; and neuropathology. Since we believe that hypoxic and ischemic hypoxia are common complications of head injury, we are also investigating in animals the sequence of events that leads to hypoxic brain damage at critical levels of cerebral perfusion pressure and systemic oxygenation, based on two hypotheses: 1) brain damge is not dependent on a failure of high energy phosphate metabolism; and 2) the weak link in persistent or irreversible hypoxic damage of the cell is failure of restoration of ion balance across the cell membrane. In the human studies, advantage is taken of the availability of non-invasive methods for anatomic localization of the lesion (CT scan) and assessment of regional cerebral blood flow (Xe133 inhalation method). Both of these new techniques permit serial observations during the course of the illness and on follow-up, which can be correlaed with outcome. When employed in conjunction with measurements of cerebral metabolic rate and intracranial pressure during the acute phase, information about the effectiveness of various therapies (e.g., mannitol and hyperventilation) can be evaluated. Parallel pathophysiologic studies are being carried out on the monkey, in whom head injuries of graded severity can be produced and better defined, and where a variety of experimental therapies can be tested.