An update to the Monro–Kellie doctrine to reflect tissue compliance after severe ischemic and hemorrhagic stroke

Autor:	Frank van Landeghem, Cassandra M. Wilkinson, Anna C J Kalisvaart, Sherry Gu, Ian R. Winship, Jerome Y. Yager, Frederick Colbourne, Tiffany F. C. Kung
Jazyk:	angličtina
Rok vydání:	2020
Předmět:	Male 0301 basic medicine medicine.medical_specialty Science Cell death in the nervous system Encephalopathy Models Biological Article Rats Sprague-Dawley 03 medical and health sciences 0302 clinical medicine Hematoma Cerebrospinal fluid Internal medicine Animals Medicine CA1 Region Hippocampal Stroke Cell Size Cerebral Hemorrhage Ischemic Stroke Intracranial pressure Neurons Intracerebral hemorrhage Multidisciplinary business.industry medicine.disease Compliance (physiology) Hemorrhagic Stroke 030104 developmental biology Cerebral blood flow Astrocytes Cardiology business 030217 neurology & neurosurgery
Zdroj:	Scientific Reports, Vol 10, Iss 1, Pp 1-15 (2020) Scientific Reports
ISSN:	2045-2322
Popis:	High intracranial pressure (ICP) can impede cerebral blood flow resulting in secondary injury or death following severe stroke. Compensatory mechanisms include reduced cerebral blood and cerebrospinal fluid volumes, but these often fail to prevent raised ICP. Serendipitous observations in intracerebral hemorrhage (ICH) suggest that neurons far removed from a hematoma may shrink as an ICP compliance mechanism. Here, we sought to critically test this observation. We tracked the timing of distal tissue shrinkage (e.g. CA1) after collagenase-induced striatal ICH in rat; cell volume and density alterations (42% volume reduction, 34% density increase; p p ≤ 0.007), but not with the Vannucci-Rice model of hypoxic-ischemic encephalopathy (2.5% volume increase, 14% density increase; p ≥ 0.05). Concerningly, this ‘tissue compliance’ appears to cause sub-lethal damage, as revealed by electron microscopy after ICH. Our data challenge the long-held assumption that ‘healthy’ brain tissue outside the injured area maintains its volume. Given the magnitude of these effects, we posit that ‘tissue compliance’ is an important mechanism invoked after severe strokes.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::fc4580caddbc255431706901eab28a71 https://doaj.org/article/0cfda1b4ad5d4c7287732a62aeecb83d Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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