Traumatic brain contusions have been associated with regional ischemia. We aimed to measure the effect of induced supra-normal values of cerebral perfusion pressure (CPP) on regional cerebral blood flow (rCBF) in the intracontusional low density area surrounding the contusional hemorrhagic core. In 7 severely head injured patients (GCS < 8) harbouring a contusion larger than 2 cm, the rCBF levels were measured, by means of Xenon-enhanced CT, in: 1) the intracontusional low density area; 2) contralaterally, in a normal brain symmetric area. CBF studies were performed at a baseline CPP of 65.3 mmHg ± 7 and after 20 minutes of nor- epinephrine-induced CPP supernormal values (88.3 mmHg ± 10.5) (p = 0.0013). A "paradoxical" reduction of rCBF levels was observed in both the intracontusional low density area (p = 0.07) and the contralateral "normal" area (p = 0.08). In particular, this decrease of rCBF in the intracontusional low density area (-25.7 ± 10 ml/lOOgr/min) (p = 0.0009) was present in only 4 cases, having a mean rCBF at baseline of 25 ± 16 ml/lOOgr/min. In the remaining 3 cases in which rCBF at baseline was abnormally low (12 ± 7 ml/ 100gr/min), rCBF values improved slightly (3.6 ± 2 ml/lOOgr/min) (p = 0.61). An acute increase of CPP seems to marginally affect rCBF in the intracontusional low density area having critically reduced initial values, but may greatly reduce rCBF in subjects starting from non-critical baseline values. © Springer-Verlag 2003.
CITATION STYLE
Chiercgato, A., Fainardi, E., Tanfani, A., Sabia, G., Martino, C., Pascarella, R., … Targa, L. (2003). Induced acute arterial hypertension and regional cerebral flow in intracontusional low density area. Acta Neurochirurgica, Supplementum, (86), 361–365. https://doi.org/10.1007/978-3-7091-0651-8_77
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