Review of the secondary injury theory of acute spinal cord trauma with emphasis on vascular mechanisms
- 1 July 1991
- journal article
- review article
- Published by Journal of Neurosurgery Publishing Group (JNSPG) in Journal of Neurosurgery
- Vol. 75 (1), 15-26
- https://doi.org/10.3171/jns.1991.75.1.0015
Abstract
✓ In patients with spinal cord injury, the primary or mechanical trauma seldom causes total transection, even though the functional loss may be complete. In addition, biochemical and pathological changes in the cord may worsen after injury. To explain these phenomena, the concept of the secondary injury has evolved for which numerous pathophysiological mechanisms have been postulated. This paper reviews the concept of secondary injury with special emphasis on vascular mechanisms. Evidence is presented to support the theory of secondary injury and the hypothesis that a key mechanism is posttraumatic ischemia with resultant infarction of the spinal cord. Evidence for the role of vascular mechanisms has been obtained from a variety of models of acute spinal cord injury in several species. Many different angiographic methods have been used for assessing microcirculation of the cord and for measuring spinal cord blood flow after trauma. With these techniques, the major systemic and local vascular effects of ac...Keywords
This publication has 100 references indexed in Scilit:
- A Randomized, Controlled Trial of Methylprednisolone or Naloxone in the Treatment of Acute Spinal-Cord InjuryNew England Journal of Medicine, 1990
- Spinal cord injury in rats: inability of nimodipine or anti-neutrophil serum to improve spinal cord blood flow or neurologic statusActa Neurologica Scandinavica, 1989
- Concentrations of Putative Neurovascular Transmitters in Major Cerebral Arteries and Small Pial Vessels of Various SpeciesJournal of Cerebral Blood Flow & Metabolism, 1987
- Functional analysis of an electromechanical spinal cord injury deviceExperimental Neurology, 1987
- Chronic regenerative changes in the spinal cord after cord compression injury in ratsSurgical Neurology, 1987
- Calcium and Ischemic InjuryNew England Journal of Medicine, 1986
- Cerebral Arterial Spasm – A Controlled Trial of Nimodipine in Patients with Subarachnoid HemorrhageNew England Journal of Medicine, 1983
- Prevention of symptomatic vasospasm by topically applied NimodipineActa Neurochirurgica, 1982
- Mitochondrial O2 use and ATP synthesis: Kinetic effects of Ca++ and HPO4−2 modulated by glucocorticoidsAnnals of Emergency Medicine, 1980
- Reassessment of cerebral capillary changes in acute global ischemia and their relationship to the "no-reflow phenomenon".Stroke, 1977