Article
Prolonged increase of the brain edema after decompressive craniectomy in mouse model of closed head injury
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Authors
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Jacek Szczygielski
- Klinik für Neurochirurgie, Universitätsklinikum des Saarlandes und Medizinische Fakultät der Universität des Saarlandes, Homburg/Saar, Germany
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Vanessa Hubertus
- Klinik für Neurochirurgie, Universitätsklinikum des Saarlandes und Medizinische Fakultät der Universität des Saarlandes, Homburg/Saar, Germany
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Eduard Kruchten
- Klinik für Neurochirurgie, Universitätsklinikum des Saarlandes und Medizinische Fakultät der Universität des Saarlandes, Homburg/Saar, Germany
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Andreas Müller
- Klink für Diagnostische und Interventionelle Radiologie, Universitätsklinikum des Saarlandes und Medizinische Fakultät der Universität des Saarlandes, Homburg/Saar, Germany
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Joachim Oertel
- Klinik für Neurochirurgie, Universitätsklinikum des Saarlandes und Medizinische Fakultät der Universität des Saarlandes, Homburg/Saar, Germany
| Published: | June 8, 2016 |
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Outline
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Objective: In previous experiments the increased brain edema in mice subjected to decompressive craniectomy after closed head injury has been documented 24h after injury. The goal of the current experiment was to analyze whether the problem of exacerbated brain swelling persists over the longer period of posttraumatic course.
Method: Anesthetized male CD-1 mice were randomly assigned into the one of the following experimental groups: sham procedure, decompressive craniectomy alone, closed head injury alone, or closed head injury followed by craniectomy at 1h posttrauma (n=7 each group). After the surgery, animals were subjected to the radiological analysis by magnetic resonance imaging (MRI) of the brain. In order to analyze the course of brain edema, the apparent diffusion coefficient maps (ADC) has been created. The radiological assessment of brain edema has been performed 1d, 3d, 7d, 14d, and 28d posttrauma. The MRI scans were subjected to volumetric analysis. The calculated edema volumes were compared between groups using one-way ANOVA. Significance was set at p < 0.05.
Results: During the entire radiological analysis, a biphasic course of posttraumatic edematous changes could be documented: In the early phase (up to 7d posttrauma) the reduced ADC values, representing a restricted water diffusion (cytotoxic edema) could be presented. Beginning at 7d, increasing hyperintensity in ADC profiles could be seen, representing most probably an increasing neuronal loss after trauma. Decompressive craniectomy caused a significant increase of brain edema during the initial posttraumatic course (p < 0.001 for 1d, 3d, 7d; p < 0.05 at 14d, compared to sham animals). This effect ameliorated in late course (no significance for timepoint 28d, as compared with sham group).
Conclusions: The demonstrated course of edematous changes in murine brain correlates well with the results of previous studies and with the clinical data. Decompressive craniectomy causes an additional brain edema in murine model of closed head injury. This effect of combined mechanical and surgical damage is prolonged, however it improves during the late posttraumatic course. The presented data may be of the great importance i.e. for the timing of cranioplasty surgeries in head trauma patients.
