Secondary Injury Factors and Preventative Treatment

摘要

The project included three independent, parallel studies: two involving experimental animals (head injury, spinal cord injury) and one involving humans (head injury). The underlying hypotheses for this work were that: (1) secondary, delayed injury resulting from actions of endogenous, autodestructive factors represents a significant contributing factor to the neurological disability that follows brain or spinal cord trauma; (2) that endogenous opioids (particularly dynorphin) and excitatory amino acids represent major classes of autodestructive factors; (3) that opioid receptor antagonists, or N-methyl-D-aspartate (NMDA) receptor antagonists administered within the first hours of trauma, improve neurological outcome; (4) that kappa-selective opioid antagonists are more effective than non-selective antagonists in treating central nervous system trauma; and (5) that magnetic resonance spectroscopy (MRS) may enhance prognostic abilities in CNS trauma by monitoring metabolic changes and the response to treatment.