VASC MECHS OF SECONDARY INSULTS IN SEVERE BRAIN INJURY

该建议的总体假设是创伤性脑损伤（TBI）在损伤后早期引起CBF减少，其通过2种机制促成脑损伤：1-如果CBF减少足够严重并且持续足够长时间，则缺血性损伤（原发性缺血;发生2-如果CBF减少更适度，可能不会发生缺血性损伤，但大脑更容易受到二次损伤（二次缺血）。严重损伤时，CBF的总体降低足以导致缺血性损伤（CBF，18 ml/100 g/min），这一发现与高死亡率相关。CBF的区域性降低严重到足以导致缺血性损伤（rCBF<18 ml/100 g/min）的情况更常见，通常见于脑挫伤和潜在的脑外血肿。甚至更常见的是，在TBI后的最初几个小时内发生CBF的中度减少，其通过增加脑氧提取来补偿。该项目将通过临床和实验室研究探讨创伤性脑损伤后血管变化的问题。方案项目有3个项目、3个核心。项目1。创伤性脑损伤后脑血流的调节。项目2.创伤性脑损伤后血管阻力增加项目3。L-精氨酸治疗创伤性脑损伤后CBF减少核心A。管理核心核心B。统计和建模核心C。分析实验室核心

The overall hypothesis of this proposal is that traumatic brain injury (TBI) causes a reduction in CBF in the early post-injury period that contributes to the brain damage by 2-mechanisms: 1-if the reduction in CBF is severe enough and lasts long enough, ischemic injury (primary ischemia; occurs 2- if the reduction is CBF is more modest, ischemic injury may not occur, but the brain is more susceptible to secondary insults (secondary ischemia). Global reductions in CBF severe enough to result in ischemic injury (CBF,18 ml/100g/min) occur with very severe injuries and this finding is associated with a high mortality rate. Regional reductions in CBF severe enough to result in ischemic injury (rCBF<18 ml/100g/min) occur more commonly and are typically found in areas of brain contusion and underlying evacuated extracerebral hematomas. Even more commonly, a moderate reduction in CBF which is compensated by increased cerebral oxygen extraction occurs during the first few hours after TBI. This program projects will approach the problem of vascular changes after traumatic brain injury with both clinical and laboratory studies. There are 3 projects and 3 cores in the program project. Project 1. Regulation of Cerebral Blood Flow after Traumatic Brain Injury. Project 2. Increased Vascular Resistance after Traumatic Brain Injury. Project 3. L-arginine Treatment of a Reduced CBF after Traumatic Brain Injury. Core A. Administrative Core Core B. Statistical and Modeling Core Core C. Analytical Lab Core