VASOGENIC EDEMA INDUCED BY COMPRESSION INJURY TO THE SPINAL NERVE ROOT - DISTRIBUTION OF INTRAVENOUSLY INJECTED PROTEIN TRACERS AND GADOLINIUM-ENHANCED MAGNETIC-RESONANCE-IMAGING
S. Kobayashi et al., VASOGENIC EDEMA INDUCED BY COMPRESSION INJURY TO THE SPINAL NERVE ROOT - DISTRIBUTION OF INTRAVENOUSLY INJECTED PROTEIN TRACERS AND GADOLINIUM-ENHANCED MAGNETIC-RESONANCE-IMAGING, Spine (Philadelphia, Pa. 1976), 18(11), 1993, pp. 1410-1424
The function of the blood-nerve barrier appears quite unique in the ne
rve root. Protein tracers that were injected into the subarachnoid spa
ce passed through the nerve root sheath and entered into the capillary
lumen in the endoneurial space but tracers that were injected intrave
nously did not appear in the endoneurial space. Marked extravasation o
f protein tracers in the nerve root was induced at the compressed part
by strong compression (60 gram force, 30 gram force) and capillaries
in the nerve root showed opening of the tight junction accompanied by
an increase in vesicular transport under the electron microscope. This
situation was reflected as high intensity on Gadolinium-enhanced magn
etic resonance imaging. In twenty-one of fifty patients with lumbar di
sc herniation, the affected nerve root was strongly enhanced by Gadoli
nium-diethylene-triaminepentaacetic acid, indicating that the blood-ne
rve barrier in the affected nerve root was broken and intraradicular e
dema was produced in these cases.