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Regional cerebral blood flow and cerebral perfusion pressure in global brain oedema induced by water intoxication

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Summary

Global brain oedema was induced by water intoxication with 50, 100, 150 and 200 ml Aqua dest./kg body weight in cats. In moderate brain oedema (following a water load of 100–150 ml/kg body weight) rCBF decreased independently of CPP but in close correlation to the increase of tissue water content. In severe brain oedema (following a water load of 150–200 ml/kg body weight) rCBF dropped progressively to very low values close to zero flow. This was paralleled by a sharp CSFP increase accompanied by an extreme CPP decrease to about 20 mm Hg and a further but less steep increase of tissue water content.

The reason for the CPP-independent rCBF decrease in moderate brain oedema seems to be a diminution of capillary diameter as a consequence of astroglia swelling both in the vicinity of and at distance from the vessels. Moreover an increase of tissue pressure also causes an increase of cerebrovascular resistance. In severe brain oedema additional extreme ICP increase and CPP decrease finally supervene causing blood flow to stop.

These results are discussed with relation to the clinical conditions of increased intracranial pressure due to brain oedema, hydrocephalus, or an intracranial expanding mass. It can be concluded that the effect of increased ICP on rCBF is different in these situations.

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Author notes

  1. G. Meinig & H. J. Reulen

    Present address: Neurosurgical Clinic, University of Mainz, Federal Republic of Germany

Authors and Affiliations

  1. Neurosurgical Clinic, University of Mainz, Federal Republic of Germany

    Chr. Magawly

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  1. G. Meinig
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  2. H. J. Reulen
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  3. Chr. Magawly
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This investigation was supported by a grant from the Deutsche Forschungsgemeinschaft.

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Meinig, G., Reulen, H.J. & Magawly, C. Regional cerebral blood flow and cerebral perfusion pressure in global brain oedema induced by water intoxication. Acta neurochir 29, 1–13 (1973). https://doi.org/10.1007/BF01414612

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