Craniocerebral trauma induces hemorheological disturbances

Several mechanisms are involved in the development of secondary ischemic br ain damage, including microthrombi formation, which is thought to play a pr ominent role. Ninety-four autopsy cases were macro- and microscopically exa mined by specific staining for fibrin, 74 of which showed cortical contusio n after a craniocerebral trauma, Twenty cases with no neurological patholog y were used as controls, Traumatic cases comprised 52 males and 22 females, with a mean age of 48 years; most cases died in the first 48 h, The total number of fibrinous microthrombi in a slice of each hemisphere was determin ed. The mean number of microthrombi found in contused hemisphere was 152 (3 7-283), with 88 in the contralateral hemisphere (21-139) as compared to 13 (0-27) in control cases, Differences were statistically significant. Globul ar microthrombi or "shock bodies" (2-60 mu diameter) were present in five c ases. Enhanced presence of microthrombi in contused brain areas, higher inc idence in young people, an increase in the amount of microthrombi up to the 9th day after injury and involvement of the contralateral hemisphere free of contusion foci were all demonstrated, Microthrombi would therefore seem to be one of the central secondary events after brain trauma to bear in min d when designing treatment strategies.