Hostname: page-component-586b7cd67f-vdxz6 Total loading time: 0 Render date: 2024-11-24T17:48:37.408Z Has data issue: false hasContentIssue false
  • English
  • Français

Does the brain become heavier or lighter after trauma?

Published online by Cambridge University Press:  01 February 2008

T. Lescot ,
V. Degos  and
L. Puybasset
T. Lescot
Affiliation:
Groupe hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris and Université Pierre et Marie Curie (Paris 6), Department of Anesthesiology and Critical Care, Paris, France
V. Degos
Affiliation:
Groupe hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris and Université Pierre et Marie Curie (Paris 6), Department of Anesthesiology and Critical Care, Paris, France
L. Puybasset*
Affiliation:
Groupe hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris and Université Pierre et Marie Curie (Paris 6), Department of Anesthesiology and Critical Care, Paris, France
*
Correspondance to: Louis Puybasset, Département d’Anesthésie-Réanimation, Groupe Hospitalier Pitié-Salpêtrière, 47, Boulevard de l’Hôpital, 75013 Paris, France. E-mail: [email protected]; Tel: +33 1 42 16 33 71; Fax: +33 1 42 16 33 70
Get access

Summary

An uncontrolled rise in intracranial pressure is probably the most common cause of death in traumatic brain-injured patients. The intracranial pressure rise is often due to cerebral oedema. Diffusion-weighted imaging has been extensively used to study cerebral oedema formation after trauma in experimental studies. Nevertheless, this technology is difficult to perform at the acute phase, especially in unstable head trauma patients. For these reasons, a safe examination allowing us to better understand the pathophysiology of cerebral oedema formation in such patients would be of great interest. Radiological attenuation is linearly correlated with estimated specific gravity in human tissue. This property gives the opportunity to measure in vivo the volume, weight and specific gravity of any tissue by computed tomography. We recently developed a software package (BrainView) for Windows workstations, providing semi-automatic tools for brain analysis from DICOM images obtained from cerebral computed tomography. In this review, we will discuss the results of the in vivo analysis of brain weight, volume and specific gravity and consider the use of this software as a new technology to improve our knowledge of cerebral oedema formation after trauma and to evaluate the severity of traumatic brain-injured patients.

Keywords

BRAIN INJURYTRAUMABLOOD–BRAIN BARRIERBRAIN OEDEMA
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 25 , Issue S42 , February 2008 , pp. 110 - 114
Copyright
Copyright © European Society of Anaesthesiology 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Barzo, P, Marmarou, A, Fatouros, P, Corwin, F, Dunbar, J. Magnetic resonance imaging-monitored acute blood–brain barrier changes in experimental traumatic brain injury. J Neurosurg 1996; 85: 1113–1121.CrossRefGoogle ScholarPubMed
2.Phelps, ME, Gado, MH, Hoffman, EJ. Correlation of effective atomic number and electron density with attenuation coefficients measured with polychromatic X-rays. Radiology 1975; 117: 585–588.CrossRefGoogle ScholarPubMed
3.Mull, RT. Mass estimates by computed tomography: physical density from CT numbers. Am J Radiol 1984; 143: 1101–1104.Google ScholarPubMed
4.Puybasset, L, Cluzel, P, Chao, N, Slutsky, AS, Coriat, P, Rouby, JJ. A computed tomography scan assessment of regional lung volume in acute lung injury. The CT Scan ARDS Study Group. Am J Respir Crit Care Med 1998; 158: 1644–1655.CrossRefGoogle ScholarPubMed
5.Puybasset, L, Gusman, P, Muller, JC, Cluzel, P, Coriat, P, Rouby, JJ. Regional distribution of gas and tissue in acute respiratory distress syndrome. III. Consequences for the effects of positive end-expiratory pressure. CT Scan ARDS Study Group. Adult Respiratory Distress Syndrome. Intensive Care Med 2000; 26: 1215–1227.CrossRefGoogle Scholar
6.Rouby, JJ, Puybasset, L, Cluzel, P, Richecoeur, J, Lu, Q, Grenier, P. Regional distribution of gas and tissue in acute respiratory distress syndrome. II. Physiological correlations and definition of an ARDS Severity Score. CT Scan ARDS Study Group. Intensive Care Med 2000; 26: 1046–1056.CrossRefGoogle ScholarPubMed
7.Rouby, JJ, Puybasset, L, Nieszkowska, A, Lu, Q. Acute respiratory distress syndrome: lessons from computed tomography of the whole lung. Crit Care Med 2003; 31: S285–S295.CrossRefGoogle ScholarPubMed
8.Lescot, T, Bonnet, MP, Zouaoui, A et al. . A quantitative computed tomography assessment of brain weight, volume, and specific gravity in severe head trauma. Intensive Care Med 2005; 31: 1042–1050.CrossRefGoogle ScholarPubMed
9.Kita, H, Marmarou, A. The cause of acute brain swelling after the closed head injury in rats. Acta Neurochir Suppl (Wien) 1994; 60: 452–455.Google ScholarPubMed
10.Marmarou, A, Bandoh, K, Yoshihara, M, Tsuji, O. Measurement of vascular reactivity in head injured patients. Acta Neurochir Suppl (Wien) 1993; 59: 18–21.Google ScholarPubMed
11.Kuhl, DE, Alavi, A, Hoffman, EJ et al. . Local cerebral blood volume in head-injured patients. Determination by emission computed tomography of 99mTc-labeled red cells. J Neurosurg 1980; 52: 309–320.CrossRefGoogle ScholarPubMed
12.Blacque-Belair, A, Mathieu de Fossey, B, Fourestier, M. Dictionnaire des Constantes Biologiques et Physiques. Paris: Maloine, 1965.Google Scholar
13.Gardenfors, A, Nilsson, F, Skagerberg, G, Ungerstedt, U, Nordstrom, CH. Cerebral physiological and biochemical changes during vasogenic brain oedema induced by intrathecal injection of bacterial lipopolysaccharides in piglets. Acta Neurochir (Wien) 2002; 144: 601–608; discussion 608–609.CrossRefGoogle ScholarPubMed
14.Talmor, D, Shapira, Y, Artru, AA et al. . 0.45% saline and 5% dextrose in water, but not 0.9% saline or 5% dextrose in 0.9% saline, worsen brain edema two hours after closed head trauma in rats. Anesth Analg 1998; 86: 1225–1229.CrossRefGoogle ScholarPubMed
15.Nath, F, Galbraith, S. The effect of mannitol on cerebral white matter water content. J Neurosurg 1986; 65: 41–43.CrossRefGoogle ScholarPubMed
16.Takagi, H, Shapiro, K, Marmarou, A, Wisoff, H. Microgravimetric analysis of human brain tissue: correlation with computerized tomography scanning. J Neurosurg 1981; 54: 797–801.CrossRefGoogle ScholarPubMed
17.Bullock, R, Smith, R, Favier, J, du Trevou, M, Blake, G. Brain specific gravity and CT scan density measurements after human head injury. J Neurosurg 1985; 63: 64–68.CrossRefGoogle ScholarPubMed