Estudio de las alteraciones de la microcirculación cerebral y caracterización de las lesiones de la barrera hematoencefalica en pacientes con traumatismo craneo-encefalico grave.

Nowadays, there are evidences about the possible role of specific endothelical cell injuries of the cerebral microcirculation in a blood brain barrier failure, which could start the development of secondary lesions (essentilally cerebral ischemia and intracranial hipertension) in patients with severe head injury. However, the lesion pattern of endothelium (stress7necrosis7 apoptosis), its evolutive characteristics, as well as the haemodynamic and metabolic factors involved in the functional failure of these cells are unknown. OBJECTIVES: 1) To characterize, to localize and to well establish the evolution of the cerebral microcirculatory abnormalities in patients died as consequence of secondary lesions appeared in severe head injuries. 2) To identify and to localize in the cerebral cortex the presence of stress cell and programmed cell death.3) To identify the characteristics of subcortical microcirculatory sustem in order to evaluate its role as weakness microcirculatory unit.