Contribution of edema and cerebral blood volume to traumatic brain swelling in head-injured patients

Anthony Marmarou, Panos P. Fatouros, Pal Barzó, Gennarina Portella, Masaaki Yoshihara, Osamu Tsuji, Takuji Yamamoto, Fred Laine, Stefano Signoretti, John D. Ward, Ross Bullock, Harold F. Young

Research output: Contribution to journalArticle

136 Citations (Scopus)

Abstract

Object. The pathogenesis of traumatic brain swelling remains unclear. The generally held view is that brain swelling is caused primarily by vascular engorgement and that edema plays a relatively minor role in the swelling process. The goal of this study was to examine the roles of cerebral blood volume (CBV) and edema in traumatic brain swelling. Methods. Both brain-tissue water and CBV were measured in 76 head-injured patients, and the relative contribution of edema and blood to total brain swelling was determined. Comparable measures of brain-tissue water were obtained in 30 healthy volunteers and CBV in seven volunteers. Brain edema was measured using magnetic resonance imaging, implementing a new technique for accurate measurement of total tissue water. Measurements of CBV in a subgroup of 31 head-injured patients were based on consecutive measures of cerebral blood flow (CBF) obtained using stable xenon and calculation of mean transit time by dynamic computerized tomography scanning after a rapid bolus injection of iodinated contrast material. The mean (± standard deviation) percentage of swelling due to water was 9.37 ± 8.7%, whereas that due to blood was -0.8 ± 1.32%. Conclusions. The results of this study showed that brain edema is the major fluid component contributing to traumatic brain swelling. Moreover, CBV is reduced in proportion to CBF reduction following severe brain injury.

Original languageEnglish
Pages (from-to)183-193
Number of pages11
JournalJournal of Neurosurgery
Volume93
Issue number2
StatePublished - Aug 1 2000
Externally publishedYes

Fingerprint

Brain Edema
Edema
Head
Cerebrovascular Circulation
Water
Xenon
Brain
Cerebral Blood Volume
Brain Injuries
Contrast Media
Blood Vessels
Volunteers
Healthy Volunteers
Tomography
Magnetic Resonance Imaging
Injections

Keywords

  • Brain swelling
  • Traumatic brain edema
  • Vascular engorgement
  • Water map

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

Cite this

Marmarou, A., Fatouros, P. P., Barzó, P., Portella, G., Yoshihara, M., Tsuji, O., ... Young, H. F. (2000). Contribution of edema and cerebral blood volume to traumatic brain swelling in head-injured patients. Journal of Neurosurgery, 93(2), 183-193.

Contribution of edema and cerebral blood volume to traumatic brain swelling in head-injured patients. / Marmarou, Anthony; Fatouros, Panos P.; Barzó, Pal; Portella, Gennarina; Yoshihara, Masaaki; Tsuji, Osamu; Yamamoto, Takuji; Laine, Fred; Signoretti, Stefano; Ward, John D.; Bullock, Ross; Young, Harold F.

In: Journal of Neurosurgery, Vol. 93, No. 2, 01.08.2000, p. 183-193.

Research output: Contribution to journalArticle

Marmarou, A, Fatouros, PP, Barzó, P, Portella, G, Yoshihara, M, Tsuji, O, Yamamoto, T, Laine, F, Signoretti, S, Ward, JD, Bullock, R & Young, HF 2000, 'Contribution of edema and cerebral blood volume to traumatic brain swelling in head-injured patients', Journal of Neurosurgery, vol. 93, no. 2, pp. 183-193.
Marmarou A, Fatouros PP, Barzó P, Portella G, Yoshihara M, Tsuji O et al. Contribution of edema and cerebral blood volume to traumatic brain swelling in head-injured patients. Journal of Neurosurgery. 2000 Aug 1;93(2):183-193.
Marmarou, Anthony ; Fatouros, Panos P. ; Barzó, Pal ; Portella, Gennarina ; Yoshihara, Masaaki ; Tsuji, Osamu ; Yamamoto, Takuji ; Laine, Fred ; Signoretti, Stefano ; Ward, John D. ; Bullock, Ross ; Young, Harold F. / Contribution of edema and cerebral blood volume to traumatic brain swelling in head-injured patients. In: Journal of Neurosurgery. 2000 ; Vol. 93, No. 2. pp. 183-193.
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