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November 1969

Brain Swelling Caused by Trauma and Arterial Hypertension: Hemodynamic Aspects

Author Affiliations

From the Section of Neurosurgery, Pennsylvania Hospital, and the Division of Neurosurgery, University of Pennsylvania, Philadelphia; and the Institute of Neurological Sciences, Killearn, Glasgow. Dr. Marshall is now at Queen's University, Kingston, Ontario.

Arch Neurol. 1969;21(5):545-553. doi:10.1001/archneur.1969.00480170117012

THE EXPERIMENTS to be reported here are part of a study of the effect of brain injury on cerebral vasomotor tone and the contribution of alterations in cerebral vasomotor reactivity to brain swelling. Closed head injury in experimental animals has been shown to impair the vasoconstrictor properties of the resistance vessels in the brain. Cerebral blood flow increases immediately following the injury1-3 as much as 250% with the postconcussive rise in blood pressure.3 Experimental head injury also causes brain swelling, manifested by marked intracranial hypertension, and cerebral blood volume may increase several fold.4,5 Interpretation of the results in some experiments has been made difficult by intracranial hemorrhage caused by the injury.4 Recently, however, Lewis et al5 reported that closed head injury in cats produces a marked increase in cerebral blood volume without hemorrhage. These observations suggest that the vasomotor properties of cerebral vessels are

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