Journal
BRAIN
Volume 145, Issue 2, Pages 787-797Publisher
OXFORD UNIV PRESS
DOI: 10.1093/brain/awab293
Keywords
cerebrospinal fluid; cardiac arrest; anoxic cerebral oedema; spreading depolarizations
Categories
Funding
- National Institute of Neurological Disorders and Stroke
- National Institute on Aging (US National Institutes of Health) [R01NS100366, RF1AG057575, K08NS089830]
- US Army Research Office [MURI W911NF1910280]
- Fondation Leducq Transatlantic Networks of Excellence Program
- Adelson Foundation
- EU [666881]
Ask authors/readers for more resources
Cerebral edema develops after anoxic brain injury and is associated with the availability of cerebrospinal fluid (CSF). An increase in CSF volume worsens the severity of edema. Edema primarily occurs in brain regions bordering CSF compartments. Anoxic brain tissue possesses a high intrinsic osmotic potential, which may contribute to the beneficial effect of therapeutic hypothermia.
Cerebral oedema develops after anoxic brain injury. In two models of asphyxial and asystolic cardiac arrest without resuscitation, we found that oedema develops shortly after anoxia secondary to terminal depolarizations and the abnormal entry of CSF. Oedema severity correlated with the availability of CSF with the age-dependent increase in CSF volume worsening the severity of oedema. Oedema was identified primarily in brain regions bordering CSF compartments in mice and humans. The degree of ex vivo tissue swelling was predicted by an osmotic model suggesting that anoxic brain tissue possesses a high intrinsic osmotic potential. This osmotic process was temperature-dependent, proposing an additional mechanism for the beneficial effect of therapeutic hypothermia. These observations show that CSF is a primary source of oedema fluid in anoxic brain. This novel insight offers a mechanistic basis for the future development of alternative strategies to prevent cerebral oedema formation after cardiac arrest.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available