Effect of THAM on Brain Oedema in Experimental Brain Injury

  • K. Yoshida
  • F. Corwin
  • A. Marmarou
Conference paper
Part of the Acta Neurochirurgica book series (NEUROCHIRURGICA, volume 51)


The metabolic brain acidosis after trauma has been thought to increase brain oedema and contribute to neurologic deterioration. Amelioration of the brain acidosis either by systemic buffering agents or by hyperventilation has been proposed as a method of treatment. The objective of this study was to explore brain oedema and the metabolic changes in brain that occur with the use of hyperventilation, Tromethamine and combination (THAM and hyperventilation) therapy in experimental fluid-percussion brain injury. Brain lactate, brain pH, inorganic phosphate (Pi) and ATP were measured by 1H and 31P magnetic resonance spectroscopy. Also Water content in brain tissue using the specific gravimetric technique were determined in 32 cats. Prolonged hyperventilation provided relative ischaemia in brain tissue and promoted more production of brain lactate, no recovery of PCr/Pi ratio, and no decrease in brain oedema. On the other hand the administration of THAM served to decrease production of brain lactate and brain oedema and promoted the recovery of cerebral energy dysfunction. THAM ameliorates the deleterious effects of hyperventilation by minimizing energy disturbance and also decreases brain oedema. We conclude that THAM may be effective in reducing brain tissue acidosis and helpful as a metabolic stabilizing agent following severe head injury.


Brain Oedema Severe Head Injury Head Injured Patient Brain Lactate Experimental Brain Injury 
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Copyright information

© Springer-Verlag 1990

Authors and Affiliations

  • K. Yoshida
    • 1
  • F. Corwin
    • 1
  • A. Marmarou
    • 1
  1. 1.Division of Neurosurgery and Radiation PhysicsMedical College of VirginiaRichmondUSA

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