Mechanisms of norepinephrine accumulation within sites of spinal cord injury

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✓ Vascularity and blood-brain barrier (BBB) function within spinal cord were studied with fluorescent microscopy at 14 intervals following 300 gm-cm injuries to the thoracolumbar spinal cord in 32 dogs. Histochemical staining with formaldehyde brought out a yellow-green fluorescence of vascular origin that was unrelated to tracer dye. This fluorescence accumulated in perivascular sites and is possibly related to catecholamine elevation within damaged spinal cord. Intrinsic CNS mechanisms for catecholamine build-up (increased transport, increased synthesis, increased release) are reviewed as well as the pharmacological action of alpha methyl tyrosine. It is hypothesized that an intrinsic CNS source of norepinephrine build-up is unlikely and that elevation of circulating catecholamine levels following stress and trauma leads to the extravasation of this material across injured BBBs within contused spinal cord.

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Address reprint requests to: W. Michael Vise, M.D., Division of Neurological Surgery, College of Medicine, The Ohio State University, 410 West 10th Avenue, Columbus, Ohio 43210.

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Figures

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    Two blood vessels in posttraumatic cord specimen with catecholamine-like extravasations (ca) secondary to blood-brain barrier injury. × 250.

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    Higher power view of blood vessel (bv) with perivascular catecholamine-like extravasation (ca) in posttraumatic spinal cord. White matter (wm). × 400.

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    Blood vessel (bv) traversing white matter (wm). Gray matter (gm). Note catecholamine-like yellow-green perivascular extravasation (ca) in specimen 10 minutes postinjury. Artifact at lower left (a). × 100.

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    Normal untraumatized spinal cord of dog showing anterior horn with surrounding white matter (wm). Evans-blue-filled blood vessels (bv) as well as several autofluorescent neurons (n) can be seen in the gray matter (gm). × 100.

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    Rapid accumulation of catecholamine-like extravasation (ca) in anterior horn of dog spinal cord 15 minutes post-trauma. Gray matter (gm). Neuron (n). Perivascular extravasation (ca) also seen at vessels coursing through white matter (wm). × 250.

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    Advancing catecholamine-like extravasations (ca) producing an intense yellow-green border around the core of gray-matter (gm) injury. Blood vessel (bv) is also seen with similar extravasation in the adjacent white matter (wm). × 250.

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