Controlled Decompression Attenuates Brain Injury in a Novel Rabbit Model of Acute Intracranial Hypertension

Abstract

This work was supported by Key Disciplines of Wuxi (ZDXK005) and Major Projects of Wuxi Health and Family Planning Commission (Z201705) Background: In the past, standard rapid decompressive craniectomy was used to alleviate the secondary damage caused by high intracranial pressure. Recent clinical studies showed that controlled decompression may have a better curative effect than rapid decompression. However, the effect on controlled decompression in animals is unclear. Material/Methods: Totally 80 healthy male New Zealand rabbits were randomly divided into a sham group (n=20), a rapid decompression group (n=30), and a controlled decompression group (n=30). An intracranial hypertension model was induced by injecting saline into an epidural balloon catheter and reducing ICP slowly and gradually by use of a pressure pump. The model was evaluated and analyzed by general observations, imaging examination, ICP values, behavioral score, brain water content, Nissl staining, and caspase-3 protein detection. Results: The mortality rate was 36.7% (11/30) in the rapid group, 20% (6/30) in the controlled group, and 5% (1/20) in the sham group. The incidence of epidural hematoma in the controlled group was lower than in the rapid group (p<0.01). The ICP was significantly lower in the controlled group than in the rapid group (p<0.001), and the behavioral score in the rapid group was higher than in the controlled group (p<0.05). There was a marked difference in brain water content between the controlled group and the rapid group (p<0.01). Nissl staining demonstrated that the ratio of Nissl body in the controlled group was significantly higher than in the rapid group (p<0.01). WB detection showed the expression of Caspase-3 in the controlled group was lower than in the rapid group (p<0.05). Conclusions: The results show the advantages of use of controlled decompression with intracranial hypertension. The animal model we developed provides a platform for further research on controlled decompression.

Middle Meningeal Arterial Embolization Combined With Drilling in the Treatment of Acute Epidural Hematoma

“…4,5 Surgery is indicated for AEDH when it causes a significant mass effect. 6 In this respect, hematoma evacuation by craniotomy can achieve better results. 6 However, surgical treatment for AEDH typically involves craniotomy and must be performed under general anesthesia.…”

“…6 In this respect, hematoma evacuation by craniotomy can achieve better results. 6 However, surgical treatment for AEDH typically involves craniotomy and must be performed under general anesthesia. This approach can lead to potential complications, such as increased blood loss during surgery and infection.…”

“…1,3,4 These imaging tests distinguish dermoid cysts from other cystic lesions on the floor of the mouth, such as ranula, cystic hygroma, and oral abscesses. 1,4,6 The treatment for dermoid cysts on the floor of the mouth is surgery, and the surgical methods are largely divided into transcervical and transoral approaches. 1,2,5 The transoral approach has the advantages of no scarring, less tissue damage, and fewer complications.…”

Controlled decompression alleviates early brain injury in rabbit intracranial hypertension model by regulating apoptosis/necroptosis

“…The protocol of intracranial hypertension model rabbit was described as a previous study 16 . After 12 h of fasting, the rabbits were anesthetized with intramuscular ketamine (50 mg·kg –1 ), and continuous intravenous infusion of sodium pentobarbital (10 mg·kg –1 ·h –1 ) via the marginal ear vein throughout the remainder of the experiment.…”

Controlled Decompression Attenuates Compressive Injury following Traumatic Brain Injury via TREK‐1‐Mediated Inhibition of Necroptosis and Neuroinflammation

“…However, the standard procedure of rapid decompression is associated with many postoperative complications, such as delayed intracranial hematoma and diffuse brain swelling [2,3]. Our previous studies have demonstrated that the controlled decompression (CDC) surgery attenuates brain injury and reduces the rates of complications after TBI [4][5][6]. However, the underlying molecular mechanism has not been determined.…”