Altered blood flow and secondary injury in experimental spinal cord trauma

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✓ A modification of the hydrogen clearance technique was used to study blood flow in the dorsolateral funiculus of traumatized thoracic spinal cord in cats. The results of this study show that ischemia occurred in all animals both at the level of trauma, and 1 cm below the site of trauma. There was, however, a period of over 1 hour after trauma during which blood flow was maintained at both sites. This investigation not only confirms the presence of ischemia in the lateral funiculus of the injured spinal cord but suggests that a period of time exists in the posttraumatic period during which pharmacological intervention may alter the ischemic response and possibly prevent secondary injury resulting from the ischemia.

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Address reprint requests to: Howard J. Senter, M.D., Department of Surgery, Section of Neurosurgery, Yale University School of Medicine, 333 Cedar Street, New Haven, Connecticut 06510.

© AANS, except where prohibited by US copyright law.

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Figures

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    Upper: Typical washout curve from the control series. Spinal cord blood flow was 11.77 ml/100 gm/min. Lower Left: Semilog transposition of Fig. 1 upper, showing a monoexponential function. Lower Right: Histological demonstration of recording site from which Fig. 1 upper was obtained. The arrow indicates the electrode tract. Bodian, × 25.

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    Control series of average spinal blood flow in 51 measurements recorded over 6 hours.

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    A: Typical washout curve of pretrauma control flow. Spinal cord blood flow (SCBF) was 9.11 ml/100 gm/min. B: Semilog transposition of A, showing a monoexponential function. C: Clearance curve recorded at the level of trauma 4 hours after a 500 gm-cm trauma: SCBF was 6.90 ml/100 gm/min. D: Semilog transposition of C, showing a monoexponential function. Inset: Histological demonstration of recording site from which C was obtained, showing typical central hemorrhagic necrosis. The arrow indicates the electrode tract. Bodian, × 25.

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    Upper: Spinal cord blood flow (SCBF) at the level of trauma as followed for 6½ hours. The SCBF of each animal is represented as percentage change from its own pretrauma control flows. A 500 gm-cm trauma was produced at time 0. Lower: Summary of data from upper graph showing percentage change of SCBF for 6½ hours after trauma recorded from the level of trauma. Vertical lines represent standard deviation, and Student t-test (p values) compares SCBF values against data from the control series during the same time period after electrode implantation (Fig. 2).

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    Upper: Spinal cord blood flow (SCBF) 1 cm below the trauma site, recorded over 6½ hours. The SCBF of each animal is represented as percentage change from its own pretrauma control flows. A 500 gm-cm trauma was produced at time 0. Lower: Summary of data from upper graph for 10 animals with SCBF recorded 1 cm below trauma site for 6½ hours. Vertical lines indicate standard deviations, and Student t-test (p values) compares SCBF against values obtained from the control series during the same period (Fig. 2).

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