Cerebral blood flow and the secondary growth of brain tissue necrosis after trauma.

Abstract

A local brain tissue necrosis from trauma progresses during the following 24 hours or longer. A decrease in cerebral blood flow has been observed both in the necrotic as well as adjacent cortical region, which may influence expansion of the lesion into the perifocal brain tissue. Currently the regional cortical blood flow (rCBF) was assessed by using scanning laser Doppler fluxmetry. Brain tissue necrosis was induced by a highly standardised cold lesion. We attempted to inhibit the development of posttraumatic ischemia in and around the focal lesion by infusion of a hypertonic/hyperoncotic saline/starch solution. The infusion therapy resulted in a temporary improvement of posttraumatic blood flow in both necrotic and distant cortical regions. However, the expansion of the focal necrosis was not reduced. Additional investigations are in progress to determine whether further amelioration with a longer duration of rCBF increase is effective in combination with methods of neuroprotection to inhibit the secondary lesion growth after a traumatic insult.