Pathophysiological mechanisms of brain edema development: role of tissue factors.

Abstract

In experiments carried out on adult rabbit "chest-head" preparations the volume changes of the exposed brain (BrV) were determined in repeated tests during a controlled increase of the systemic venous pressure (SVP) of about 13 mm Hg. The changes of both SVP and BrV were usually parallel at the onset of the experiments, but when the brains became preedematous hysteresis appeared in the plots of their relationships. The hysteresis increased gradually (sometimes with periods of partial decrease) thus indicating a delay in the draining of blood from the brain's venous system and in the removal of excess extracellular fluid from the cebral tissue. Evidence for water filtration through the capillary walls during increase of the SVP, and, thus, of brain intravascular pressure, was obtained by detecting the dynamics of [Na+] and [K+] in the extracellular fluid of the cerebral cortex by ion-selective electrodes. This process appeared reversible in normal brains while in the preedematous ones the excessive water filtration resulted in brain edema. The preedematous state of the brain is believed to be caused by changes of the mechanical properties of brain tissue and/or by changes in osmolarity.