Focal ischemia due to traumatic contusions documented by stable xenon-CT and ultrastructural studies

M. L. Schroder, J. P. Muizelaar, Ross Bullock, J. B. Salvant, J. T. Povlishock

Research output: Contribution to journalArticle

123 Citations (Scopus)

Abstract

A traumatic cerebral contusion causes a zone of perifocal neuronal necrosis, the cause of which is not known; the surgical management of these lesions remains controversial. To determine the pathophysiological mechanisms responsible for brain damage after contusions, the authors performed cerebral blood flow (CBF) mapping studies and related these to change in local cerebral blood volume (CBV) and ultrastructure. In 11 severely head injured patients with contusion, CBF and CBV were measured in pericontusional areas using stable xenon-computerized tomography (CT). These studies demonstrated a profound reduction in perilesional CBF (mean 17.5 ± 4 ml/100 g/min), which was always accompanied by a zone of edema defined by CT density measurements. Mean CBV in these regions was 2.3 ± 0.4 ml/100 g, a reduction to approximately one-half the value of 4.8 ml/100 g found in the nonedematous regions, and to approximately 35% of the value of 6.0 ml/100 g found in normal volunteers. Ultrastructural analysis of the pericontusional tissue, taken at surgery in four patients with high intracranial pressure showed glial swelling with narrowing of the microvascular lumina due to massive podocytic process swelling. Additionally, some suggestion of vascular occlusion due to erythrocyte and leukocyte stasis was seen. These data support the conclusion that microvascular compromise by compression and/or occlusion is a major event associated with profound perilesional hypoperfusion, which is a uniform finding within edematous pericontusional tissue.

Original languageEnglish
Pages (from-to)966-971
Number of pages6
JournalJournal of Neurosurgery
Volume82
Issue number6
StatePublished - Jan 1 1995
Externally publishedYes

Fingerprint

Cerebrovascular Circulation
Xenon
Contusions
Ischemia
Tomography
Intracranial Pressure
Neuroglia
Blood Vessels
Edema
Healthy Volunteers
Leukocytes
Necrosis
Erythrocytes
Head
Brain
Cerebral Blood Volume

Keywords

  • cerebral blood flow
  • cerebral blood volume
  • cerebral contusion
  • cerebral edema
  • microvasculature
  • ultrastructure

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

Cite this

Schroder, M. L., Muizelaar, J. P., Bullock, R., Salvant, J. B., & Povlishock, J. T. (1995). Focal ischemia due to traumatic contusions documented by stable xenon-CT and ultrastructural studies. Journal of Neurosurgery, 82(6), 966-971.

Focal ischemia due to traumatic contusions documented by stable xenon-CT and ultrastructural studies. / Schroder, M. L.; Muizelaar, J. P.; Bullock, Ross; Salvant, J. B.; Povlishock, J. T.

In: Journal of Neurosurgery, Vol. 82, No. 6, 01.01.1995, p. 966-971.

Research output: Contribution to journalArticle

Schroder, ML, Muizelaar, JP, Bullock, R, Salvant, JB & Povlishock, JT 1995, 'Focal ischemia due to traumatic contusions documented by stable xenon-CT and ultrastructural studies', Journal of Neurosurgery, vol. 82, no. 6, pp. 966-971.
Schroder ML, Muizelaar JP, Bullock R, Salvant JB, Povlishock JT. Focal ischemia due to traumatic contusions documented by stable xenon-CT and ultrastructural studies. Journal of Neurosurgery. 1995 Jan 1;82(6):966-971.
Schroder, M. L. ; Muizelaar, J. P. ; Bullock, Ross ; Salvant, J. B. ; Povlishock, J. T. / Focal ischemia due to traumatic contusions documented by stable xenon-CT and ultrastructural studies. In: Journal of Neurosurgery. 1995 ; Vol. 82, No. 6. pp. 966-971.
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