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Traumatic brain edema in diffuse brain injury and cerebral contusion:Update of current imaging study Tatsuro Kawamata 1 , Yoichi Katayama 1 1Department of Neurological Surgery, Nihon University School of Medicine Keyword: brain edema , brain swelling , cerebral contusion , diffuse brain injury , imaging study pp.241-247
Published Date 2006/4/10
DOI https://doi.org/10.11477/mf.1431100132
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The generally held concept during the past several decades is that traumatic brain swelling is primarily caused by increase in vascular permeability(vasogenic edema)and by increase in cerebral blood volume(CBV)resulting from cerebral vascular engorgement(hyperemia). However the resent imaging studies using CT and/or MRI clearly demonstrate that traumatic brain edema is a combination of vasogenic and cellular with the cellular component predominating, and that CBV is reduced in the most cases with severe brain swelling. Although these results suggest that ischemic brain damage is closely involved in trauma-induced brain edema, the mechanisms underlying the edema formation cannot be fully explained by ischemia alone. Cerebral blood flow decreases but still exists in traumatized brain, suggesting that water supply from the blood vessels in not completely interrupted. In cerebral contusion, diffusion MR imaging demonstrates that cell in the central area of contusion undergo shrinkage, disintegration and homogenization, whereas cellular swelling is predominant in the peripheral area of contusion. It appears that the capacitance for edema fluid accumulation increases in the central area, and edema fluid propagation decreases in the peripheral area. Furthermore, necrotic brain tissue sampled from the central area of contusion demonstrates a very high osmolality, which may generate osmotic potential to attract water. Combination of these circumstances may facilitate edema fluid accumulation in the central area of contusion. This article provides an update of the current progress of imaging study investigating traumatic brain edema in diffuse brain injury and cerebral contusion.


Copyright © 2006, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1243 印刷版ISSN 0001-8724 医学書院

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