Responses of posttraumatic pericontusional cerebral blood flow and blood volume to an increase in cerebral perfusion pressure.

Détails

ID Serval
serval:BIB_73ACD79B797B
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Responses of posttraumatic pericontusional cerebral blood flow and blood volume to an increase in cerebral perfusion pressure.
Périodique
Journal of Cerebral Blood Flow and Metabolism
Auteur⸱e⸱s
Steiner L.A., Coles J.P., Johnston A.J., Czosnyka M., Fryer T.D., Smielewski P., Chatfield D.A., Salvador R., Aigbirhio F.I., Clark J.C., Menon D.K., Pickard J.D.
ISSN
0271-678X
Statut éditorial
Publié
Date de publication
2003
Peer-reviewed
Oui
Volume
23
Numéro
11
Pages
1371-1377
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Résumé
In and around traumatic contusions, cerebral blood flow (CBF) is often near or below the threshold for ischemia. Increasing cerebral perfusion pressure (CPP) in patients with head injuries may improve CBF in these regions. However, the pericontusional response to this intervention has not been studied. Using positron emission tomography (PET), we have quantified the response to an increase in CPP in and around contusions in 18 contusions in 18 patients. Regional CBF and cerebral blood volume (CBV) were measured with PET at CPPs of 70 and 90 mmHg using norepinephrine to control CPP. Based upon computed tomography, regions of interest (ROIs) were placed as two concentric ellipsoids, each of 1-cm width, around the core of the contusions. Measurements were compared with a control ROI in tissue with normal anatomic appearance. Baseline CBF and CBV increased significantly with increasing distance from the core of the lesion. The increase in CPP led to small increases in CBF in all ROIs except the core. The largest absolute CBF increase was found in the control ROI. Relative CBF increases did not differ between ROIs so that ischemic areas remained ischemic. Pericontusional oedema on computed tomography was associated with lower absolute values of CBF and CBV but did not differ from nonoedematous tissue in the relative response to CPP elevation.
Mots-clé
Adolescent, Adult, Blood Volume, Brain Edema/physiopathology, Brain Injuries/pathology, Brain Injuries/physiopathology, Cerebrovascular Circulation/physiology, Female, Humans, Male, Middle Aged, Norepinephrine/administration & dosage, Perfusion, Pressure, Regional Blood Flow/physiology, Tomography, Emission-Computed
Pubmed
Web of science
Création de la notice
29/12/2009 18:04
Dernière modification de la notice
20/08/2019 15:31
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