Neuroprotective efficacy of decompressive craniectomy after controlled cortical impact injury in rats: An MRI study

Tian, Runfa; Han, Li; Hou, Zhiyong; Hao, Shuyu; Mao, Xiang; Zhu, Zhendan; Xue, Tao; Zhang, Qi; Liu, Baiyun

doi:10.1016/j.brainres.2015.06.039

Cited by 7 publications

(2 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Possibly this uncontrolled brain edema development seen already 6 h posttrauma ( 20 ) lead to impaired neurological recovery and increased neuronal loss ( 22 ). These observations vary from reports of other groups reporting neuroprotective effects of experimental surgical decompression after TBI ( 14 , 15 , 127 ). Significant differences of the TBI model used (diffuse vs. focal trauma pattern) as well as differing injury severity may be quoted as reasons for the diverse conclusions of animal studies on decompressive craniectomy.…”

Section: Discussioncontrasting

confidence: 94%

Changes in Posttraumatic Brain Edema in Craniectomy-Selective Brain Hypothermia Model Are Associated With Modulation of Aquaporin-4 Level

et al. 2018

View full text Add to dashboard Cite

Both hypothermia and decompressive craniectomy have been considered as a treatment for traumatic brain injury. In previous experiments we established a murine model of decompressive craniectomy and we presented attenuated edema formation due to focal brain cooling. Since edema development is regulated via function of water channel proteins, our hypothesis was that the effects of decompressive craniectomy and of hypothermia are associated with a change in aquaporin-4 (AQP4) concentration. Male CD-1 mice were assigned into following groups (n = 5): sham, decompressive craniectomy, trauma, trauma followed by decompressive craniectomy and trauma + decompressive craniectomy followed by focal hypothermia. After 24 h, magnetic resonance imaging with volumetric evaluation of edema and contusion were performed, followed by ELISA analysis of AQP4 concentration in brain homogenates. Additional histopathological analysis of AQP4 immunoreactivity has been performed at more remote time point of 28d. Correlation analysis revealed a relationship between AQP4 level and both volume of edema (r2 = 0.45, p < 0.01, **) and contusion (r2 = 0.41, p < 0.01, **) 24 h after injury. Aggregated analysis of AQP4 level (mean ± SEM) presented increased AQP4 concentration in animals subjected to trauma and decompressive craniectomy (52.1 ± 5.2 pg/mL, p = 0.01; *), but not to trauma, decompressive craniectomy and hypothermia (45.3 ± 3.6 pg/mL, p > 0.05; ns) as compared with animals subjected to decompressive craniectomy only (32.8 ± 2.4 pg/mL). However, semiquantitative histopathological analysis at remote time point revealed no significant difference in AQP4 immunoreactivity across the experimental groups. This suggests that AQP4 is involved in early stages of brain edema formation after surgical decompression. The protective effect of selective brain cooling may be related to change in AQP4 response after decompressive craniectomy. The therapeutic potential of this interaction should be further explored.

show abstract

Section: Discussioncontrasting

confidence: 94%

Changes in Posttraumatic Brain Edema in Craniectomy-Selective Brain Hypothermia Model Are Associated With Modulation of Aquaporin-4 Level

et al. 2018

View full text Add to dashboard Cite

show abstract

“…In a rat model, surgical decompression after FPI led to reduced brain edema formation with diminished AQP4 expression 48 h later ( 22 ). In CCI-treated rats, a positive effect of decompression (reduced volume of edema and contusion due to improved metabolic profile of the brain) was reported by Tian et al up to 7d after trauma ( 23 ). Using the same model, Hou et al reported improvement of behavioral changes by decompression, probably due to reduced impairment of synaptic function ( 24 ).…”

Section: Discussionmentioning

confidence: 85%

Prolonged course of brain edema and neurological recovery in a translational model of decompressive craniectomy after closed head injury in mice

Szczygielski,

Hubertus,

Kruchten

et al. 2023

Front. Neurol.

View full text Add to dashboard Cite

BackgroundThe use of decompressive craniectomy in traumatic brain injury (TBI) remains a matter of debate. According to the DECRA trial, craniectomy may have a negative impact on functional outcome, while the RescueICP trial revealed a positive effect of surgical decompression, which is evolving over time. This ambivalence of craniectomy has not been studied extensively in controlled laboratory experiments.ObjectiveThe goal of the current study was to investigate the prolonged effects of decompressive craniectomy (both positive and negative) in an animal model.MethodsMale mice were assigned to the following groups: sham, decompressive craniectomy, TBI and TBI followed by craniectomy. The analysis of functional outcome was performed at time points 3d, 7d, 14d and 28d post trauma according to the Neurological Severity Score and Beam Balance Score. At the same time points, magnetic resonance imaging was performed, and brain edema was analyzed.ResultsAnimals subjected to both trauma and craniectomy presented the exacerbation of the neurological impairment that was apparent mostly in the early course (up to 7d) after injury. Decompressive craniectomy also caused a significant increase in brain edema volume (initially cytotoxic with a secondary shift to vasogenic edema and gliosis). Notably, delayed edema plus gliosis appeared also after decompression even without preceding trauma.ConclusionIn prolonged outcomes, craniectomy applied after closed head injury in mice aggravates posttraumatic brain edema, leading to additional functional impairment. This effect is, however, transient. Treatment options that reduce brain swelling after decompression may accelerate neurological recovery and should be explored in future experiments.

show abstract

Decompressive craniectomy in acute brain injury

Brown

Wijdicks

2017

Handbook of Clinical Neurology

View full text Add to dashboard Cite

Neuroprotective efficacy of decompressive craniectomy after controlled cortical impact injury in rats: An MRI study

Cited by 7 publications

References 42 publications

Changes in Posttraumatic Brain Edema in Craniectomy-Selective Brain Hypothermia Model Are Associated With Modulation of Aquaporin-4 Level

Changes in Posttraumatic Brain Edema in Craniectomy-Selective Brain Hypothermia Model Are Associated With Modulation of Aquaporin-4 Level

Prolonged course of brain edema and neurological recovery in a translational model of decompressive craniectomy after closed head injury in mice

Decompressive craniectomy in acute brain injury

Contact Info

Product

Resources

About