An experimental study of craniocerebral trauma during ethanol intoxication

Critical Care Medicine
M S Albin, L Bunegin

Abstract

This study evaluates the effects of ethanol (blood levels of 200 mg/dl for one hour) and dimethyl sulfoxide (DMSO) on cerebral lesion volumes after pressure-induced focal ischemia during normotension and induced hypotension in the canine. This experimental design simulates the situation where an individual imbibes two to four alcoholic drinks over a one-hour period, then drives a motor vehicle, and suffers a head injury either without significant blood loss or where the cerebral perfusion pressure is reduced to the lower limits of autoregulation (mean arterial pressure of 50 mm Hg). Ethanol was shown to increase brain lesion volumes in both the normotensive (4.5 +/- 0.7 cm3) and hypotensive (14.9 +/- 2.2 cm3) groups when compared to controls (0.8 +/- 0.3 and 2.9 +/- 0.4 cm3, respectively). DMSO markedly attenuated this response in the normotensive and hypotensive ethanol groups. It is thought that the intermediate metabolites of ethanol provide a large source of hydroxyl-free radicals in the presence of neuronal tissue damage and that these free radicals are effectively scavenged by DMSO.

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