{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T12:42:10Z","timestamp":1791031330284,"version":"4.1.0"},"reference-count":77,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1984,8]]},"abstract":"<jats:p content-type=\"fine-print\">\u2713 Cerebral blood flow (CBF) measurements were made in 75 adult patients with closed head injuries (mean Glasgow Coma Scale score 6.2), using the xenon-133 intravenous injection method with eight detectors over each hemisphere. All patients were studied acutely within 96 hours of trauma, and repeatedly observed until death or recovery (total of 361 examinations). Arteriojugular venous oxygen differences (AVDO<jats:sub>2<\/jats:sub>) were obtained in 55 of the patients, which permitted assessment of the balance between metabolism and blood flow, and provided estimates of cerebral metabolic rate for oxygen (CMRO<jats:sub>2<\/jats:sub>).<\/jats:p>\n<jats:p content-type=\"fine-print\">Based on mean regional CBF, the patients were classified into two groups: those who exhibited hyperemia on one or more examinations, and those who had a consistently reduced flow during their acute illness. \u201cHyperemia\u201d was defined as a normal or supernormal CBF in the presence of coma, a definition that was independently confirmed by narrow AVDO<jats:sub>2<\/jats:sub>'s indicative of \u201cluxury perfusion.\u201d During coma, all patients showed a significant depression in CMRO<jats:sub>2<\/jats:sub>.<\/jats:p>\n<jats:p content-type=\"fine-print\">Forty-one patients (55%) developed an acute hyperemia with an average duration of 3 days, while 34 patients (45%) consistently had subnormal flows. Although more prevalent in younger patients, hyperemia was found at all age levels (15 to 85 years). There was a highly significant association between hyperemia and the occurrence of intracranial hypertension, defined as an intracranial pressure above 20 mm Hg. Patients with reduced flow showed little or no evidence of global cerebral ischemia, but instead revealed the expected coupling of CBF and metabolism. The CBF responses to hyperventilation were generally preserved, with the hyperemic patients being slightly more reactive. In 10 patients with reduced flow, hyperventilation resulted in wide AVDO<jats:sub>2<\/jats:sub>'s suggestive of ischemia.<\/jats:p>","DOI":"10.3171\/jns.1984.61.2.0241","type":"journal-article","created":{"date-parts":[[2009,5,8]],"date-time":"2009-05-08T16:21:56Z","timestamp":1241799716000},"page":"241-253","source":"Crossref","is-referenced-by-count":709,"title":["Cerebral blood flow and metabolism in comatose patients with acute head injury"],"prefix":"10.3171","volume":"61","author":[{"given":"Walter D.","family":"Obrist","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas W.","family":"Langfitt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jurg L.","family":"Jaggi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julio","family":"Cruz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas A.","family":"Gennarelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"725","DOI":"10.1161\/01.STR.4.5.725","article-title":"The relationship of regional cerebrovascular CO2 reactivity to blood pressure and regional resting flow.","volume":"4","author":"Ackerman","year":"1973"},{"key":"b2","series-title":"Scientific Foundations of Neurology.","first-page":"478","article-title":"The pathology of blunt head injuries","author":"Adams","year":"1972"},{"key":"b3","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"569","DOI":"10.1161\/01.STR.9.6.569","article-title":"Cerebral blood flow and metabolism in man following cardiac arrest.","volume":"9","author":"Beckstead","year":"1978"},{"key":"b4","series-title":"J Neurol Neurosurg Psychiatry","doi-asserted-by":"publisher","first-page":"384","DOI":"10.1136\/jnnp.37.4.384","article-title":"Cerebral blood flow and oxygen uptake, and cerebrospinal fluid biochemistry in severe coma.","volume":"37","author":"Brodersen","year":"1974"},{"key":"b5","series-title":"Arch Neurol","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1001\/archneur.1973.00490230070010","article-title":"Cerebral hyperemia in electrically induced epileptic seizures.","volume":"28","author":"Brodersen","year":"1973"},{"key":"b6","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"170","DOI":"10.3171\/jns.1981.54.2.0170","article-title":"Diffuse cerebral swelling following head injuries in children: the syndrome of \u201cmalignant brain edema.\u201d","volume":"54","author":"Bruce","year":"1981"},{"key":"b7","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"131","DOI":"10.3171\/jns.1973.38.2.0131","article-title":"Regional cerebral blood flow, intracranial pressure, and brain metabolism in comatose patients.","volume":"38","author":"Bruce","year":"1973"},{"key":"b8","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"611","DOI":"10.3171\/jns.1980.52.5.0611","article-title":"Neurological course and correlated computerized tomography findings after severe closed head injury.","volume":"52","author":"Clifton","year":"1980"},{"key":"b9","series-title":"Acta Anaesth Scand","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1111\/j.1399-6576.1978.tb01299.x","article-title":"Cerebral metabolic rate of oxygen (CMRO2) in the acute phase of brain injury.","volume":"22","author":"Cold","year":"1978"},{"key":"b10","series-title":"Human Aging. 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