Artikel
The impact of brain spatula on the cell integrity of the retracted brain tissue in a porcine model: A feasibility study
Tierexperimentelle Studie zum Einfluss von Hirnspateln auf die Zellintegrität des retrahierten Hirngewebes: eine Machbarkeitsstudie
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Autoren
Veröffentlicht: | 23. April 2004 |
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Gliederung
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Objective
We describe a porcine brain injury model following brain retraction by brain spatula with regard to experimental setup and biomechanical aspect. The aim was to identify the primary and secondary pathological and functional sequelae associated with brain cortical contusions and perifocal edema following brain retraction.
Methods
In 11 anaesthetized male pigs, the right frontal brain was retracted in the interhemispheric cleft by a brain spatulum with various pressures applied by the gravitation force of weights from 10 to 70 g for the duration of 30 minutes. The integrity of the retracted brain tissue was monitored for changes in intracranial pressure and in perfusion of the cortex using a Laser Doppler Perfusion Imager (LDPI, Lawrenz). To evaluate the extent of edema and cortical contusions MRI was performed 30 minutes and 72 hours after brain retraction. The resulting ischemia and edema were histopathologically assessed using Luxol Fast Blue and Cresylviolet as well as Fluoro-Jade-B staining for neuronal damage.
Results
Following this protocol, a retraction pressure applied by 10 and 20 g weights (n=5) over a duration of 30 minutes caused a mean rise of ICP to 9.6±3.4 mmHg, a decrement in mean cortical perfusion from 754.5±22.1 PU/cm2 to 659.3±131.5 PU/cm2. Retracting the brain with a weight of 30-70 g (n=6), the mean ICP increased to 22.0±4.3 mm Hg and caused the cortical perfusion to drop from a mean of 651.6±99.7 PU/cm2 to 437.4±140.1 PU/cm2 corresponding to a substantial edema on FLAIR images and irreversible neuronal damage on Fluoro-Jade-B-staining.
Conclusions
The cortical impact caused by the retracting brain spatulum was found to be critical at weights beyond 20 g over a period of 30 minutes resulting in a significant decrement in cortical perfusion and irreversible neuronal damage.