Immediate cerebrovascular responses to closed head injury in the rat.

Changes in cerebrovascular dynamics were investigated immediately after closed head injury in the rat using a newly developed closed head injury model developed by Marmarou et al. Intracranial pressure (ICP) and mean arterial blood pressure (MABP) were monitored before and after trauma. Regional cerebral blood flow (rCBF), regional cerebral plasma volume (rCPV), and blood-brain barrier (BBB) permeability were measured autoradiographically with iodo[14C]antipyrine [14C]sucrose, and [alpha-14C]aminoisobutyric acid, respectively. rCBF responses to induced hypertension after trauma were measured by laser-Doppler flowmetry to investigate the status of autoregulation. Before injury, baseline ICP values ranged from 6 to 10 mm Hg in all animals. Immediately after trauma, ICP increased synchronously with MABP to > 100 mm Hg and then rapidly returned to baseline values: MABP increased rapidly by 20% after trauma and returned to baseline values within 30 sec. At 30 sec after injury, a significant increase in rCBF was observed in five subcortical regions (p < 0.05), and a significant increase in rCPV was observed in the frontal cortex, parietal cortex, thalamus, and hypothalamus (p < 0.05). At 10 min after injury, BBB permeability (the transfer constant for [alpha 14C]aminoisobutyric acid) was < 0.1 mL/kg/min for all regions except those with a relatively permeable BBB, for example, median eminence, choroidal plexus, pineal body, and pituitary gland. Induced hypertension resulted in a prolonged increase in rCBF after trauma. Thus, in this closed head injury model, which is not associated with marked hypertension or prolonged BBB disruption, widespread increases in rCBF and impaired cerebral autoregulation were apparent immediately after injury.