Dimethyl sulfoxide in the treatment of experimental brain compression

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✓ Forty rhesus monkeys were subjected to acute experimental head injury by extradural balloon compression of the brain. A critical endpoint in the compression was used to inject either saline, urea, or dimethyl sulfoxide (DMSO). All saline-treated animals died. Ten of 15 urea-treated animals survived, while 14 of 15 DMSO-injected monkeys survived. The incidence of neurological deficits seen in survivors was four for urea and one for DMSO. It is concluded that DMSO is capable of modifying the mortality rate and posttraumatic sequelae of brain injury in the experimental model used.

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Address reprint requests to: J. C. de la Torre, M.D., University of Chicago Hospitals, Chicago, Illinois 60637.

© AANS, except where prohibited by US copyright law.

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Figures

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    Experimental set-up showing monkey placed in a stereotaxic headholder. Bifrontal burr holes are made for recording intracranial pressure and for extradural compressing balloon. Biparietal leads are screwed into skull in contact with the dura for EEG recordings. Pial window may be placed contralateral to the compressing balloon.

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    Three bands of polygraph recordings measuring physiological parameters during extradural balloon compression, endpoint, and stabilization or death. During compression, no remarkable changes are seen. At endpoint, respiration (Resp.) shows high amplitude slow wave activity culminating in a variable period of apnea. Following apnea, a spontaneous respiratory gasp is seen (arrow) and the drug or saline is injected. Prior to the apneic period, a rise in systemic arterial pressure (BP) is evident, accompanied by a sustained rise in intracranial pressure (ICP). The last 0.2 cc of fluid increment in the extradural balloon is marked by a circled arrow. Left carotid blood flow (Lt. Car. B.F.) is not measurable during endpoint. Left and right parietal EEG is seen flattening during apnea. After urea or DMSO is injected, ICP falls suddenly with urea and more gradually with DMSO, while the drop after saline is only partial. Stabilization of all parameters was seen in the surviving animals 8 to 10 min following the endpoint except after saline injection where 9 of 10 monkeys died before balloon compression (10th monkey died within 10 hours after surgery). Time markers are 25 mm/min and 25 mm/sec for fast tracings.

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    Three bands of polygraph recordings measuring physiological parameters during extradural balloon compression, endpoint, and stabilization or death. (See Fig. 2 for detailed explanation.)

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    Three bands of polygraph recordings measuring physiological parameters during extradural balloon compression, endpoint, and stabilization or death. (See Fig. 2 for detailed explanation.)

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    Left: Pial vessels during apneic endpoint as seen through the cranial window. Large avascular areas are seen in cortex while vessels are barely discernible due to arrest (v marks) or severe reduction of blood flow caused by contralateral balloon compression. Right: Pial blood flow 30 to 60 min after DMSO returns to almost complete revascularization as evidenced by the return of vessels (o marks) where prior arrest of blood flow had occurred. Double and single rows of dots indicate the orientation of both cortical fields. Balloon compression was maintained for an hour after drug treatment, × 50.

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