[Variations of the cerebral blood flow after hyperbaric oxygenation in traumatic coma]. 1975

B Philippon, and R C Munsch

We have previously shown (Ref. I) the absence of variations in average cerebral blood flow, measured by the method of LASSEN, following treatment of traumatic coma by means of hyperbaric oxygenation patients presenting with brainstem contusion, during 2 hours of HBO (at 2.5 times atmospheric pressure) measurements of cerebral blood flow were made using a single detecting probe, before and two hours after terminating HBO. Measurements in 9 patients demonstrated variations in cerebral flow greater than predicted by experimental error (+/- 4%): 5 measurements (these with initial flow less than 31 ml/mn/100 g increased following OHB, while 4 measurements (these with initial flow greater than 31 ml/mn/100 g) decreased following OHB. In order to determine the significance of these variations, we studied the correlation between two methods of calculating cerebral blood flow : the exponential (bicompartimental) method, and the stochastic method, assuming lambda the coefficient of partition, tobe equal to I. These two method of calculation appear to be independant ; thus, the observed correlation (r = 0.74, p less than 0.01) tends to validite the measured variations in flow. This finding is further supported by the calculated correlation between the change in flow as measured by the exponential and that measured by the stochastic method (r = 0.684, p less than 0.05). Thus, we feel that measured changes in flow represent changes in cerebral perfusion, and cannot be attributed to the method of calculation. The bio exponential method of calculation of flow, D = Dg + Dw (with Dg = fg. Wg = "index of grey perfusion" and Dw = fw. Ww = "index of white perfusion", where fg = lambda1. (see article), and where Wg and Ww represent the percentage of the grey and white substance) permit calculation of a highly significant correlation between the change in flow and the grey perfusion index (r = 0.83, p less than 0.01). This correlation, previously described in the literature, appears to explain the observed findings in terms of the variations in perfusion of the grey compartment. However, there exists an equally significant correlation, but negative, between the variations of the grey and white perfusion index (r = 0.824, p less than 0.01). This correlation seems to indicate the presence of an inverse relationship between flow to grey and white substances, tending to minimize the variations of the total flow after OHB. We can then formulate an explanatory hypothesis: if one assumes that the diminution of intracranial pressure during OHB, by decreasing cerebral edema, hastens the recovery of perfusion in the damaged zones, then the response to therapy with hyperbaric oxygenation should differ, depending on whether the tissues were healthy or damaged. Healthy tissues should show a decrease, while damaged zones should show an increase in flow following OHB. This mechanism would appear to explain, in relation to lesions located predominantly in grey or white matter, the observed negative correlation between blood flow to the two compartments.

UI MeSH Term Description Entries
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D008954 Models, Biological Theoretical representations that simulate the behavior or activity of biological processes or diseases. For disease models in living animals, DISEASE MODELS, ANIMAL is available. Biological models include the use of mathematical equations, computers, and other electronic equipment. Biological Model,Biological Models,Model, Biological,Models, Biologic,Biologic Model,Biologic Models,Model, Biologic
D012039 Regional Blood Flow The flow of BLOOD through or around an organ or region of the body. Blood Flow, Regional,Blood Flows, Regional,Flow, Regional Blood,Flows, Regional Blood,Regional Blood Flows
D001783 Blood Flow Velocity A value equal to the total volume flow divided by the cross-sectional area of the vascular bed. Blood Flow Velocities,Flow Velocities, Blood,Flow Velocity, Blood,Velocities, Blood Flow,Velocity, Blood Flow
D001921 Brain The part of CENTRAL NERVOUS SYSTEM that is contained within the skull (CRANIUM). Arising from the NEURAL TUBE, the embryonic brain is comprised of three major parts including PROSENCEPHALON (the forebrain); MESENCEPHALON (the midbrain); and RHOMBENCEPHALON (the hindbrain). The developed brain consists of CEREBRUM; CEREBELLUM; and other structures in the BRAIN STEM. Encephalon
D001930 Brain Injuries Acute and chronic (see also BRAIN INJURIES, CHRONIC) injuries to the brain, including the cerebral hemispheres, CEREBELLUM, and BRAIN STEM. Clinical manifestations depend on the nature of injury. Diffuse trauma to the brain is frequently associated with DIFFUSE AXONAL INJURY or COMA, POST-TRAUMATIC. Localized injuries may be associated with NEUROBEHAVIORAL MANIFESTATIONS; HEMIPARESIS, or other focal neurologic deficits. Brain Lacerations,Acute Brain Injuries,Brain Injuries, Acute,Brain Injuries, Focal,Focal Brain Injuries,Injuries, Acute Brain,Injuries, Brain,Acute Brain Injury,Brain Injury,Brain Injury, Acute,Brain Injury, Focal,Brain Laceration,Focal Brain Injury,Injuries, Focal Brain,Injury, Acute Brain,Injury, Brain,Injury, Focal Brain,Laceration, Brain,Lacerations, Brain
D002560 Cerebrovascular Circulation The circulation of blood through the BLOOD VESSELS of the BRAIN. Brain Blood Flow,Regional Cerebral Blood Flow,Cerebral Blood Flow,Cerebral Circulation,Cerebral Perfusion Pressure,Circulation, Cerebrovascular,Blood Flow, Brain,Blood Flow, Cerebral,Brain Blood Flows,Cerebral Blood Flows,Cerebral Circulations,Cerebral Perfusion Pressures,Circulation, Cerebral,Flow, Brain Blood,Flow, Cerebral Blood,Perfusion Pressure, Cerebral,Pressure, Cerebral Perfusion
D003128 Coma A profound state of unconsciousness associated with depressed cerebral activity from which the individual cannot be aroused. Coma generally occurs when there is dysfunction or injury involving both cerebral hemispheres or the brain stem RETICULAR FORMATION. Comatose,Pseudocoma,Comas,Pseudocomas
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D006931 Hyperbaric Oxygenation The therapeutic intermittent administration of oxygen in a chamber at greater than sea-level atmospheric pressures (three atmospheres). It is considered effective treatment for air and gas embolisms, smoke inhalation, acute carbon monoxide poisoning, caisson disease, clostridial gangrene, etc. (From Segen, Dictionary of Modern Medicine, 1992). The list of treatment modalities includes stroke. Oxygenation, Hyperbaric,Hyperbaric Oxygen Therapy,Hyperbaric Oxygen Therapies,Hyperbaric Oxygenations,Oxygen Therapies, Hyperbaric,Oxygen Therapy, Hyperbaric,Oxygenations, Hyperbaric,Therapies, Hyperbaric Oxygen,Therapy, Hyperbaric Oxygen

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