ノナカ　マサヒロ   NONAKA MASAHIRO   埜中　正博    所属   関西医科大学  脳神経外科学講座    職種   教授
論文種別	原著(症例報告除く)
言語種別	英語
査読の有無	査読あり
表題	Immediate coma following inertial brain injury dependent on axonal damage in the brainstem.
掲載誌名	正式名：Journal of neurosurgery 略　 称：J Neurosurg ISSNコード：0022308500223085
掲載区分	国外
巻・号・頁	93(2),pp.315-322
著者・共著者	Smith D H, Nonaka M, Miller R, Leoni M, Chen X H, Alsop D, Meaney D F
担当区分	2nd著者
発行年月	2000/08
概要	OBJECT:Immediate and prolonged coma following brain trauma has been shown to result from diffuse axonal injury (DAI). However, the relationship between the distribution of axonal damage and posttraumatic coma has not been examined. In the present study, the authors examine that relationship.METHODS:To explore potential anatomical origins of posttraumatic coma, the authors used a model of inertial brain injury in the pig. Anesthetized miniature swine were subjected to a nonimpact-induced head rotational acceleration along either the coronal or axial plane (six pigs in each group). Immediate prolonged coma was consistently produced by head axial plane rotation, but not by head coronal plane rotation. Immunohistochemical examination of the injured brains revealed that DAI was produced by head rotation along both planes in all animals. However, extensive axonal damage in the brainstem was found in the pigs injured via head axial plane rotation. In these animals, the severity of coma was found to correlate with both the extent of axonal damage in the brainstem (p<0.01) and the applied kinetic loading conditions (p<0.001). No relationship was found between coma and the extent of axonal damage in other brain regions.CONCLUSIONS:These results suggest that injury to axons in the brainstem plays a major role in induction of immediate posttraumatic coma and that DAI can occur without coma.
DOI	10.3171/jns.2000.93.2.0315
PMID	10930019