Summary
Four to five months after exposure of the right occipital lobe of the Macaca mulatta to 3500 rad or orthovoltage irradiation, in a single dose, there is a proliferative and degenerative lesion accompanied by a massive break in the blood-brain barrier. The resulting vasogenic edema causes rather abrupt, gross swelling in the ipsilateral hemisphere, compression of the contralateral hemisphere, with ventricular dilation, and distortion of midline structures, that may result in herniation through the incisura and foramen magnum. The regional cerebral blood flow, determined by [14C] antipyrine method at successive stages in the development and resolution of the delayed brain swelling shows a reduction of blood flow in white and gray matter, first regionally, then throughout the ipsilateral hemisphere and finally, throughout the brain. This is accompanied by an increase in CSF pressure, CSF lactic dehydrogenase and total protein, and clinical signs of increased intracranial pressure. With resolution of CSF pressure, there is a return to baseline of CSF chemistry and partial resolution of the other parameters. The cerebral blood flow shows a greater recovery in gray than white matter, but there remains a diffuse depression suggesting a long-term impairment in cellular metabolism and/or blood flow regulatory mechanisms. Six months after exposure of the whole brain to 6000 rad of supervoltage radiation, in a fractionated dose over six weeks, there are multiple small areas of necrosis scattered throughout the forebrain white matter, with a few in midline nuclear masses and the brain stem. When examined, the individual lesions are found to be in different stages of breakdown and repair, with focal areas of edema accompanying the former. The location of the lesions determines the presence or absence of focal neurologic signs. In the aggregate they may cause diffuse brain swelling, reflected by papilledema. From six to twelve months there is a recession in numbers of fresh necrotic lesions, but adequate repair seldom if ever occurs.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Brightman, M.W., Klatzo, I., Olsson, Y., Reese, T.S.: The blood-brain barrier to proteins under normal and pathological conditions. J. neurol. Sci. 10, 215–239 (1970)
Caveness, W.F., Carsten, A.L., Roizin, L., Schadé, J.P.: Pathogenesis of x-irradiation effects in the monkey cerebral cortex. Brain Res. 7, 1–119 (1968)
Caveness, W.F., Tanaka, A., Hess, K.H., et al.: Delayed brain swelling and functional derangement after x-irradiation of the right visual cortex in the Macaca mulatta. Radiat. Res. 57, 104–120 (1974)
Cervós-Navarro, J.: Elektronenmikroskopische Befunde an den Kapillaren des Kaninchengehirns nach der Einwirkung ionisierender Strahlen. Arch. Psychiat. Nervenkr. 205, 204–222 (1964)
Clemente, C.D., Holst, E.A.: Pathological changes in neurons, neuroglia and blood-brain barrier induced by x-irradiation of heads of monkeys. Arch. Neurol. Psychiat. (Chicago) 71, 66–79 (1954)
Denekamp, J.: Changes in the rate of proliferation in normal tissue after irradiation. In: Proc. of the Vth Internat. Congr. of Radiation Research. Nygaard, O.F., Adler, H.I., Sinclair, W.K. (eds.). New York-London: Academic Press 1975, pp. 810–825
Godwin-Austen, R.B., Howell, D.A., Worthington, B.: Observations on radiation myelopathy. Brain 98, 557–568 (1975)
Haymaker, W.: Effects of ionizing radiation on nervous tissue. In: Structure and Function of Nervous Tissue. Bourne, G.H. ( ed.). New York-London: G.H. (ed.). 1969, Vol. III, pp. 441–518
Hirano, A.: The fine structure of brain edema. In: The Structure and Function of the Nervous System. Bourne, G.H. ( ed.). New York-London: G.H. (ed.). 1969, Vol. II, pp. 69–136
Hopewell, J.W., Wright, E.A.: The nature of latent cerebral irradiation damage and its modification by hypertension. Brit. J. Radiol. 43, 161–167 (1970)
Hsu, Y.K., Chang, C.P., Hsieh, C.K., Lyman, R.S.: Effect of roentgen rays on the permeability of the barrier between blood and cerebrospinal fluid. Chin. J. Physiol. 10, 379–390 (1936)
Jellinger, K., Sturm, K.: Delayed radiation myelopathy in man. J. neurol. Sci. 14, 389–408 (1971)
Klatzo, I.: Pathological aspects of the blood-brain barrier (BBB). In: International Symposium on Neurotoxicology. New York: Raven Press 1976 (in press)
Lampert, P.W., Davis, R.L.: Delayed effects of radiation on the human central nervous system. “Early” and “late” delayed reactions. Neurology (Minneap.) 14, 912–917 (1964)
Lierse, W., Franke, H.: Histochemical and ultrastructural events in radiation injury of the brain. Proc. VIth Internat. Congr. Neuropath. Paris: Masson 1970, pp. 228–236
McDonald, L.W., Hayes, T.L.: The role of capillaries in the pathogenesis of delayed radionecrosis of brain. Amer. J. Path. 50, 745–764 (1967)
Mogilnitzky, B.N., Podljaschuk, L.D.: Roentgenstrahlen und sogenannte “hamato-enzephalische Barriere”. Fortschr. Röntgenstr. 41, 66–75 (1930)
Mrsulja, B.B., Mrsulja, B.J., Ito, U., Fujimoto, T., Walker, J.T., Jr., Spatz, M., Klatzo, I.: Cerebral ischemia: Some new aspects of postischemic period. Proceedings of the International Symposium “Pathophysiological Biochemical and Morphological Aspects of Cerebral Ischemia and Arterial Hypertension”. Warsaw, Poland. To be published
Nakagaki, H., Brunhart, G., Kemper, T.L., Caveness, W.F.: Monkey brain damage from radiation in the therapeutic range. J. Neurosurg. 44, 3–10 (1976)
Oldendorf, W.H.: The blood-brain barrier. International Symposium on the Ocular and Cerebrospinal Fluids. May 3–6, 1976, Sponsored by the John E. Fogarty International Center, National Institutes of Health, Bethesda, Maryland
Pasztor, E., Symon, L.: The lack of precise regulation of blood flow in cerebral white matter. In: Pathology of Cerebral Microcirculation. Cervós-Navarro, J. (ed.). Berlin-New York: Walter de Gruyter 1974, pp. 153–158
Reinhold, H.S., Buisman, G.H.: Radiosensitivity of capillary endothelium. Brit. J. Radiol. 46, 54–57 (1973)
Stearner, S.P., Devine, R.L., Christian, E.J.B.: Late changes in the irradiated microvasculature: An electron microscope study of the effects of fission neutrons. Radiat. Res. 65, 351–370 (1976)
Tanaka, A., Ueno, H., Yamashita, Y., Caveness, W.F.: Regional cerebral blood flow in delayed brain swelling following x-irradiation of the right occipital lobe in the monkey. Brain Res. 96, 233–246 (1975)
Upton, S.C.: The interplay of viruses and radiation in carcinogenesis. In: Proc. of the Vth Internat. Congr. of Radiation Research. Nygaard, O.F., Adler, H.I., Sinclair, W.K. (eds.). New York: Academic Press 1975, pp. 895–908
Zeman, W.: Disturbances of nucleic acid metabolism preceding delayed radio-necrosis of nervous tissue. Proc. nat. Acad. Sci. (Wash.) 50, 626–630 (1963)
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1976 Springer-Verlag Berlin · Heidelberg
About this paper
Cite this paper
Caveness, W.F., Kemper, T.L., O’Neill, R.R. (1976). Delayed Vasogenic Edema Following Irradiation of the Monkey Brain. In: Pappius, H.M., Feindel, W. (eds) Dynamics of Brain Edema. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-66524-0_10
Download citation
DOI: https://doi.org/10.1007/978-3-642-66524-0_10
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-540-08009-1
Online ISBN: 978-3-642-66524-0
eBook Packages: Springer Book Archive