Correlation of cell apoptosis with brain edema and elevated intracranial pressure in traumatic brain injury.
OBJECTIVE
To study the correlation between brain edema, elevated intracranial pressure (ICP) and cell apoptosis in traumatic brain injury (TBI).


METHODS
In this study, totally 42 rabbits in 7 groups were studied. Six of the animals were identified as a control group, and the remaining 36 animals were equally divided into 6 TBI groups. TBI models were produced by the modified method of Feeney. After the impact, ICP of each subject was recorded continuously by an ICP monitor until the animal was sacrificed at scheduled time. The apoptotic brain cells were detected by an terminal deoxynucleotide-transferase-mediated dUTP-digoxigenin nick end labeling (TUNEL) assay. Cerebral water content (CWC) was measured with a drying method and calculated according to the Elliott formula. Then, an analysis was conducted to determine the correlation between the count of apoptotic cells and the clinical pathological changes of the brain.


RESULTS
Apoptotic cell count began to increase 2 h after the impact, and reached its maximum about 3 days after the impact. The peak value of CWC and ICP appeared 1 day and 3 days after the impact, respectively. Apoptotic cell count had a positive correlation with CWC and ICP.


CONCLUSIONS
In TBI, occurrence of brain edema and ICP increase might lead to apoptosis of brain cells. Any therapy which can relieve brain edema and/or decrease ICP would be able to reduce neuron apoptosis, thereby to attenuate the secondary brain damage.
Yang
Xiao-feng
XF
Department of Neurosurgery, the Second Hospital, Medical College of Zhejiang University, Hangzhou, 310009, China. zjcswk@163.net
Liu
Wei-guo
WG
Shen
Hong
H
Gong
Jiang-biao
JB
Yu
Jun
J
Hu
Wei-wei
WW
Lü
Shi-ting
ST
Zheng
Xiu-jue
XJ
Fu
Wei-ming
WM
D000818:Animals; D017209:Apoptosis; D001929:Brain Edema / Q000209:etiology / Q000378:metabolism / Q000473:pathology*; D001930:Brain Injuries / Q000150:complications / Q000473:pathology* / Q000503:physiopathology; D002452:Cell Count; D004195:Disease Models, Animal; D020287:In Situ Nick-End Labeling; D019586:Intracranial Hypertension / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D008297:Male; D009336:Necrosis / Q000235:genetics / Q000473:pathology; D011817:Rabbits; D012016:Reference Values; D013687:Telencephalon / Q000378:metabolism; D014867:Water / Q000378:metabolism
D014867:Water