Tissue Pressure in Ischemic Brain Edema

  • Fausto Iannotti
  • Julian T. Hoff


Very early after an ischemic insult to the brain, edema develops3. Ischemic edema, according to Klatzo, results from a combination of insults which develop sequentially. Initially, the Blood Brain Barrier (BBB) to macromolecules is not damaged and water accumulates in the intracellular compartment, which expands, while the extracellular space is reduced. Hours to days after the ischemic insult, vasogenic edema develops. If time influences the evolution of edema, then the decrease in cerebral blood flow (CBF) triggers its formation. A disturbance of water homeostasis with cellular swelling, seems to occur in the baboon3 and gerbil2 cortex when rCBF falls below 19–20 ml/100 g/min. When the decrease in flow is more severe, more water accumulates in the brain tissue . From this perspective we regard edema as an expression of the ischemic damage. However, as suggested by Hossmann and Schuier , when edema forms in an ischemic area the damage becomes progressive and rCBF falls further as edema develops.


Cerebral Blood Flow Middle Cerebral Artery Occlusion Brain Edema Ischemic Insult Vasogenic Edema 
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  1. 1.
    Brock M, Winkelmüller W, Poll W, Markakis E, Dietz H: Measurement of brain tissue presusre. Lancet I 595–596 (1972).CrossRefGoogle Scholar
  2. 2.
    Crockard A, Iannotti F, Hunstock AT, Smith RD, Harris RJ, Symon L: Cerebral blood flow and edema following carotid occlusion in the gerbil. Stroke vol 11: 494–498 (1980).CrossRefGoogle Scholar
  3. 3.
    Fujimoto T, Walker JT, Spatz M, Klatzo I: Pathophysiologic aspects of ischemic edema. In: Dynamics of Brain Edema, Pappius HM, Feindel W, (Eds) Springer Verlag New York 171–180 (1976).CrossRefGoogle Scholar
  4. 4.
    Hayakawa T, Waltz AG: Intracranial pressure, blood pressure, and pulse rate after occlusion of a middle cerebral artery in cats. J. Neurosurg vol 43: 399–407 (1975).CrossRefGoogle Scholar
  5. 5.
    Hossmann KA, Schuier FJ: Experimental brain infarcts in cats. I Pathophysiological observations. Stroke 11: 583–592 (1980).CrossRefGoogle Scholar
  6. 6.
    Iannotti F, Hoff JT (in preparation) (1982).Google Scholar
  7. 7.
    Marmarou A, Takagi H, Walstra G, Shulman K: The time course of cerebral blood flow in a controlled model of brain edema. Acta Neurol Scand (suppl) 72: 380–381 (1979).Google Scholar
  8. 8.
    Marmarou A, Takagi H, Shulman K: Biomechanics of brain edema and effects on local cerebral blood flow. In: Brain edema, Cervos-Navarro J, Ferszt R (Eds) Raven Press, New York, Adv Neurol 28: 345–358 (1980).Google Scholar
  9. 9.
    Marmarou A, Tanaka K, Shulman K: An improved gravimetric measure of cerebral edema. Neurosurg 56: 246–253 (1982).CrossRefGoogle Scholar
  10. 10.
    Matsuoka Y, Hossmann KA: The effect of induced hypertension on pial artery micropressure after middle cerebral artery occlusion in cats. J Cereb Blood Flow Metabol vol (suppl) 1: 164–165 (1981).Google Scholar
  11. 11.
    O’Brien MD, Waltz AG: Intracranial pressure gradients caused by experimental cerebral ischemia and edema. Stroke 4: 201–206 (1973).CrossRefGoogle Scholar
  12. 12.
    Pasztor E, Symon L, Dorsch NWC: The hydrogen clearance method in assessment of blood flow in cortex, white matter and deep nuclei of baboons. Stroke 4: 556–567 (1973).CrossRefGoogle Scholar
  13. 13.
    Reulen HJ, Kreysch HG: Measurement of brain tissue pressure in cold induced oedema. Acta Neurochir 29: 29–40 (1973).CrossRefGoogle Scholar
  14. 14.
    Reulen HJ, Graham R, Spatz M, Klatzo I: Role of pressure gradients and bulk flow in dynamics of vasogenic brain edema. J Neurosurg 46: 24–35 (1977).CrossRefGoogle Scholar
  15. 15.
    Schuier FJ, Hossmann KA: Experimental brain infarcts in cats II. Ischemic Brain Edema. Stroke 11: 593–601 (1980).CrossRefGoogle Scholar
  16. 16.
    Shulman K, Marmarou A, Weitz S: In: Intracranial Pressure II, Lundberg N, Ponten V, Brock M (Ed) Springer Verlag, New York 221–223 (1975).CrossRefGoogle Scholar
  17. 17.
    Symon L: Regional cerebrovascular responses to acute ischaemia in normocapnia and hypervapnia. J Neurol Neuros Psych 33: 756–762 (1970).CrossRefGoogle Scholar
  18. 18.
    Symon L, Branston NM, Chikovani O: Ischemic brain edema following middle cerebral artery occlusion in baboons relationship between regional cerebral water content and blood flow at 1 to 2 hours. Stroke 10: 184–191 (1979).CrossRefGoogle Scholar

Copyright information

© Plenum Press, New York 1984

Authors and Affiliations

  • Fausto Iannotti
    • 1
  • Julian T. Hoff
    • 1
  1. 1.Section of NeurosurgeryUniversity of Michigan AnnArborUSA

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