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The Blood-Nerve Barrier and the Pathologic Significance of Nerve Edema

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Implications of the Blood-Brain Barrier and Its Manipulation

Abstract

Edema occurs in peripheral nerves when excessive fluid accumulates either in the interstitium or within the myelin sheath, creating a disturbance in the endoneurial microenvironment. Nerve edema is concomitant with many peripheral neuropathies and can alter the endoneurial microenvironment by increasing pressure, reducing blood flow, or altering electrolyte concentrations in the endoneurial fluid (EF). Not only is it a complication of several diseases of peripheral nerve, but it can independently injure the nerve fiber. This is due to the vulnerability of the vasa nervorum to internal and external pressure. These vessels are characterized by numerous anastomoses that form the epineural and perineurial vascular plexuses (Figs. 1 and 2). Since they pierce the perineurium, pressure at this point causes ischemia, damaging nerve fibers. This chapter reviews new findings concerning the physiology of the endoneurial environment, mechanisms of increased endoneural fluid pressure (EFP), and their pathologic complications.

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Abbreviations

BNB:

blood–nerve barrier

CNS:

central nervous system

CSF:

cerebrospinal fluid

EAN:

experimental allergic neuritis

EF:

endoneurial fluid

EFP:

endoneurial fluid pressure

FITC:

fluorescein isothiocyanate

HCP:

hexachlorophene

HRP:

horseradish peroxidase

PPD:

purified protein derivative

TET:

triethylin

TFA:

transfascicular area

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Author information

Authors and Affiliations

  1. Department of Pathology, University of California, San Diego, La Jolla, California, 92093, USA

    Henry C. Powell

  2. Departments of Anesthesiology and Neurosciences, Veterans Administration Medical Center, La Jolla, California, 92093, USA

    Robert R. Myers

Authors
  1. Henry C. Powell
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  2. Robert R. Myers
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Editor information

Editors and Affiliations

  1. The Oregon Health Sciences University School of Medicine, Portland, Oregon, USA

    Edward A. Neuwelt M.D.

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© 1989 Plenum Publishing Corporation

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Powell, H.C., Myers, R.R. (1989). The Blood-Nerve Barrier and the Pathologic Significance of Nerve Edema. In: Neuwelt, E.A. (eds) Implications of the Blood-Brain Barrier and Its Manipulation. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-0701-3_8

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  • DOI: https://doi.org/10.1007/978-1-4613-0701-3_8

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4612-8039-2

  • Online ISBN: 978-1-4613-0701-3

  • eBook Packages: Springer Book Archive

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