Document Detail


Early metabolic characteristics of lesion and nonlesion tissue after head injury.
MedLine Citation:
PMID:  19293825     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We defined lesion and structurally normal regions using magnetic resonance imaging at follow-up in patients recovering from head injury. Early metabolic characteristics in these regions of interest (ROIs) were compared with physiology in healthy volunteers. Fourteen patients with severe head injury had positron emission tomography within 72 h, and magnetic resonance imaging at 3 to 18 months after injury. Cerebral blood flow (CBF), oxygen utilization (CMRO(2)), and oxygen extraction fraction (OEF) were all lower in lesion ROIs, compared with nonlesion and control ROIs (P<0.001); however, there was substantial overlap in physiology. Control ROIs showed close coupling among CBF, blood volume (CBV), and CMRO(2), whereas relationships within lesion and nonlesion ROIs were abnormal. The relationship between CBF and CMRO(2) generally remained coupled but the slope was reduced; that for CBF and OEF was variable; whereas that between CBF and CBV was highly variable. There was considerable heterogeneity between and within patients. Although irreversibly damaged tissue is characterized by marked derangements in physiology, a more detailed analysis shows acute changes in physiology and physiologic relationships within regions of the brain that appear structurally normal at follow-up. Such pathophysiological derangements may result in selective neuronal loss and impact on functional outcome.
Authors:
Jonathan P Coles; Alison S Cunningham; Raymond Salvador; Doris A Chatfield; Adrian Carpenter; John D Pickard; David K Menon
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-03-18
Journal Detail:
Title:  Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism     Volume:  29     ISSN:  1559-7016     ISO Abbreviation:  J. Cereb. Blood Flow Metab.     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-04-30     Completed Date:  2009-05-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8112566     Medline TA:  J Cereb Blood Flow Metab     Country:  United States    
Other Details:
Languages:  eng     Pagination:  965-75     Citation Subset:  IM    
Affiliation:
Division of Anaesthesia, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Brain / metabolism*,  pathology*,  radionuclide imaging
Brain Injuries / metabolism*,  pathology*,  physiopathology,  radionuclide imaging
Cerebrovascular Circulation / physiology*
Female
Glasgow Coma Scale
Humans
Magnetic Resonance Imaging
Male
Oxygen Consumption / physiology*
Oxygen Radioisotopes
Positron-Emission Tomography
Retrospective Studies
Time Factors
Young Adult
Grant Support
ID/Acronym/Agency:
//Medical Research Council
Chemical
Reg. No./Substance:
0/Oxygen Radioisotopes

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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