Summary
The morphological characteristics of cerebral contusions in head trauma patients suggest that an increase in cerebrovascular permeability is responsible for the contusion edema which develops within 1–3 days posttrauma. In the present study, 10 patients with cerebral contusions (mean age, 38 years old; 8 males and 2 females) were examined by gadolinium (Gd)-DTPA enhanced magnetic resonance imaging (MRI) at 1–2 days after trauma. Gd-DTPA (0.3 mmol/kg) was infused intravenously over a period of 30 min. Mris were taken before, and at 2 and 4 hours after initiation of the Gd-DTPA administration. It was found that contusion edema areas were frequently enhanced by Gd-DTPA at 2 hours. The enhancement diminished at 4 hours. These findings appear to be inconsistent with the results of previously reported similar studies in which enhancement was detected at 6–9 days posttrauma but not during the period earlier than 6 days. This discrepancy may be attributable to the presence of a high blood concentration of Gd-DTPA for a longer period of time and a delay in the time at which Mris were taken in the present study. The present data indicate that an increased cerebrovascular permeability occurs at as early as 1–2 days posttrauma, and suggest that contusion edema which progresses during the initial 1–3 days may be at least partially vasogenic in nature.
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References
Hirano A (1969) The structure of brain edema. In: Bourne GH (ed) The structure and function of nervous system. Academic Press, New York, pp 89–135
Ito U, Reulen H-J, Tomita H, et al (1988) Formation and porpagation of brain oedema fluid around human brain metastasis. A CT study. Acta Neurochir (Wien) 90: 35–41
Katayama Y, Tsubokawa T, Kinoshita K, et al (1992) Intraparenchymal fluid-blood levels in traumatic intracerebral hematomas. Neuroradiology 34: 381–383
Katayama Y, Tsubokawa T, Miyazaki S, et al (1990) Oedema fluid formation within contused brain tissue as a cause of medically uncontrollable elevation of intracranial pressure in head trauma patients. Acta Neurochir (Wien) [Suppl] 51: 308–310
Lang DA, Hadley DM, Teasdale GT, et al (1991) Gadolinium DTPA enhanced magnetic resonance imaging in acute head injury. Acta Neurochir (Wien) 109: 5–11
Marmarou A, Takagi H, Shulman K (1980) Biomechanics of brain edema and effects on local cerebral blood flow. In: Advances in neurology, Vol 28. Raven, New York, pp 345–358
Niendorf HP, Haustein J, Louton T, et al (1991) Safety and tolerance after intravenous administration of 0.3 mmol/Kg Gd-DPTA. Results of randomized, controlled clinical trial. Invest Radiol [Suppl] 26: 221–223
Reulen HJ, Graham R, Spatz M, et al (1977) Role of pressure gradients and bulk flow in dynamics of vasogenic brain edema. J Neurosurg 46: 24–35
Todd NV, Graham DI (1990) Blood-brain barrier damage in traumatic brain contusion. Acta Neurochir (Wien) [Suppl] 51: 296–299
Tornheim PA, Prioleau GR, McLaurin RA, et al (1984) Acute responses to experimental blunt head trauma topography of cerebral cortical edema. J Neurosurg 60: 473–480
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© 1994 Springer-Verlag
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Kushi, H., Katayama, Y., Shibuya, T., Tsubokawa, T., Kuroha, T. (1994). Gadolinium DTPA-Enhanced Magnetic Resonance Imaging of Cerebral Contusions. In: Ito, U., et al. Brain Edema IX. Acta Neurochirurgica, vol 60. Springer, Vienna. https://doi.org/10.1007/978-3-7091-9334-1_129
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DOI: https://doi.org/10.1007/978-3-7091-9334-1_129
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