Absence of Brain Edema After Reversible Osmotic Opening of the Blood-Brain Barrier
The blood-brain barrier in the rhesus monkey was opened reversibly by perfusing 2.2 mol/kg recrystallized DL-lactamide solution into the internal carotid artery. Gross neurologic sequelae did not occur and no changes were observed in brain water, sodium or potassium content 48 h after osmotic opening, demonstrating the nondestructive nature of such reversible opening. Prolonged barrier opening caused by perfusion of unrecrystallized lactamide, on the other hand, resulted in brain edema and electrolyte changes that were maximal 24–48 h later, consistent with entry of plasma water and salt into the brain. Barrier damage in this case was due presumably to a cytotoxic factor that could be removed by recrystallization. The results support the suggestion that a threshold intensity and duration of barrier opening is required to produce brain edema. Measurable edema may have been absent after reversible opening because interstitial albumin was excreted or metabolized by 48 h, or because a low brain compliance prevented significant water accumulation.
KeywordsBrain Edema Reversible Opening Barrier Opening Electrolyte Change Capillary Filtration
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