Feb 1, 1976

Dynamic changes in regional CBF, intraventricular pressure, CSF pH and lactate levels during the acute phase of head injury

Journal of Neurosurgery
E M EnevoldsenR Malmros

Abstract

The authors measured regional cerebral 133xenon (133Xe) blood flow (rCBF), intraventricular pressure (IVP), cerebrospinal fluid (CSF) pH and lactate, systemic arterial blood pressure (SAP), and arterial blood gases during the acute phase in 23 comatose patients with severe head injuries. The IVP was kept below 45 mm Hg. The rCBF was measured repeatedly, and the response to induced hypertension and hyperventilation was tested. Most patients had reduced rCBF. No correlation was found between average CBF and clinical condition, and neither global nor regional ischemia contributed significantly to the reduced brain function. No correlation was found between CBF and IVP or CBF and cerebral perfusion pressure (CPP). The CSF lactate was elevated significantly in patients with brain-stem lesions, but not in patients with "pure" cortical lesiosn. The 133Xe clearance curves from areas of severe cortical lesions had very fast initial components called tissue peaks. The tissue peak areas correlated with areas of early veins in the angiograms, indicating a state of relative hyperemia, referred to as tissue-peak hyperemia. Tissue-peak hyperemia was found in all patients with cortical laceration or severe contusion but not in patients with br...Continue Reading

Mentioned in this Paper

Ischemia
Mild Traumatic Brain Injury
Xenon Radioisotopes
Reactive Hyperemia
Lactate
Blood Circulation Time
Cerebrospinal Fluid pH
Brain
D-lactate Measurement
Nonpenetrating Wounds

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