实验性脑外伤后持续的轴突和血管改变。

J T Povlishock, H A Kontos
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引用次数: 67

摘要

用液体冲击脑损伤动物模型研究了创伤后轴突和血管变化的过程。为了评估轴突的变化,我们研究了在遭受轻微到中度损伤的猫的大脑和小脑输出神经中,辣根过氧化物酶的顺行运输,这些猫在创伤事件中存活了几个小时到几个月。为了评估血管变化,研究人员给猫安装了颅窗,这样既可以对损伤后的头部血管系统进行直接功能研究,也可以在死后收集所研究的血管进行形态学分析。在液体冲击脑损伤后,轴突发生轻微的局灶性扰动,在12至24小时内,这种扰动逐渐变得严重,结果轴突肿胀,与其远端节段分离,从而形成扩大的反应性肿胀。在持续存活的情况下,一些肿胀完好无损,另一些肿胀退化,还有一些肿胀表现出显著的再生反应。这种再生反应,以再生发芽和圆锥状生长为特征,在所有的生存期都持续存在。液体冲击损伤后,动脉小动脉立即扩张,形态改变,功能异常。这些血管异常是由花生四烯酸通过环加氧酶加速代谢介导的,从而导致氧自由基的产生。自由基,如超氧阴离子,在受伤后的第一个小时内继续产生,因此,与观察到的轴突反应类似,继续促进大脑对创伤的反应。虽然这些轴突和血管的变化似乎没有因果关系,但它们都表现为初始损伤的连续体,如果继发性损伤发生,它们可能会相互联系。
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Continuing axonal and vascular change following experimental brain trauma.

The course of axonal and vascular change following trauma was investigated in an animal model of fluid-percussion brain injury. To assess axonal change, the anterograde transport of horseradish peroxidase in selected cerebral and cerebellar efferents was studied in cats that had sustained minor to moderate injuries and had survived the traumatic episode for periods ranging from several hours to several months. To assess vascular change, cats were equipped with cranial windows, which allowed for both the direct functional study of the pial vasculature following injury and the postmortem harvesting of the studied vessels for morphologic analyses. Following fluid-percussion brain injury, a subtle focal perturbation of the axon occurred, and over a 12 to 24 hour period, this perturbation became progressively severe, with the result that the axon swelled, separated from its distal segment, and thereby formed an enlarged reactive swelling. With continued survival, some swellings persisted intact, others degenerated, and others demonstrated a dramatic regenerative response. This regenerative response, characterized by regenerative sprouting and growth conelike outgrowths, persisted through all survival periods considered. Immediately following the induction of the fluid-percussion injury, the pial arterioles dilated, manifested morphologic change, and displayed functional abnormalities. These vascular abnormalities appeared mediated by an accelerated metabolism of arachidonate via cyclooxygenase, which results in the generation of oxygen radicals. Radicals, such as the superoxide anion, continue to be produced within the first hour following injury and thus, similar to the observed axonal responses, continue to contribute to the brain's response to trauma. Although these axonal and vascular changes do not appear to be causally related, they both appear as a continuum of the initial insult and may become interlinked should a secondary insult ensue.

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