Stroke, Vol 20, 372-377, Copyright © 1989 by American Heart Association
A Guha, CH Tator and J Rochon
We looked at the relation between systemic arterial blood pressure and
recovery from spinal cord injury by inducing both hypertension and
hypotension in 25 rats randomly allocated to five equal groups. The rats
received no injury, a mild (2.3-g), or a severe (53.0-g) spinal cord injury
lasting 1 minute. We used the hydrogen clearance technique to measure
spinal cord blood flow at the injury site (T1) and at an adjacent site
(C6). Mean systemic arterial blood pressure was either increased with
adrenaline or decreased by phlebotomy in 20-mm-Hg intervals except for the
severe-injury group, in which the posttraumatic pressure could only be
increased with adrenaline. Spinal cord blood flow remained constant in the
no-injury group between 81 and 180 mm Hg. After a mild injury, induced
moderate hypertension (121-140 mm Hg) improved spinal cord blood flow
significantly, whereas hypotension decreased it in a linear fashion. Severe
injury caused a marked decrease in spinal cord blood flow and mean systemic
arterial blood pressure. Even extreme hypertension (161-180 mm Hg) induced
by adrenaline did not significantly increase spinal cord blood flow at T1
but caused hyperemia at C6 due to loss of autoregulation. In conclusion,
normotension should be attempted, irrespective of the severity of spinal
cord injury. Induced hypertension after severe spinal cord injury was not
beneficial in improving spinal cord blood flow at the injury site while
potentially increasing hemorrhage and edema.
ARTICLES
Spinal cord blood flow and systemic blood pressure after experimental spinal cord injury in rats
Playfair Neuroscience Unit, Toronto Western Hospital, University of Toronto, Canada.
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