Neurodegenerative diversity in human cortical contusion: histological analysis of tissue derived from decompressive craniectomy.
The principal aim in the management of patients with cerebral contusion (CC) following severe traumatic brain injury (TBI) is the prevention, amelioration, and treatment of secondary neuronal dysfunction and pathology. Distinguishing between irreversibly damaged and surviving tissue could have considerable therapeutic and prognostic implications for patients. To characterize structurally the neuronal compartment of the contused region in samples derived from patients who suffered severe TBI and were subjected to decompressive craniectomy, we used NeuN, a neuronal marker. We determined that NeuN "patches", sectors with loss of NeuN immunoreactivity (NeuN-IR), represented 25% of the area among the analyzed cases. We also found a 67% decrease in NeuN levels via Western blot. Tissue adjoining patches of NeuN-IR were considered "preserved" due to the apparent normal density of neurons and conservation of the six cortical layers. Nevertheless, these sectors retained only 39% of their neurons with the classical pattern described for normal NeuN-IR. Using Fluorojade we identified a 16-fold increase in density of moribund neurons in "preserved" sectors when compared to controls. Additionally these abnormalities were enhanced 5-fold in "patches" of NeuN-IR when compared to preserved regions. Therefore, NeuN/Fluorojade abnormalities are indicative of different cell fates characteristic of CC tissue. This analysis addressed exclusively the neuronal compartment and provides new insights into the degenerative state of neurons in the contused region that is likely to contribute to clinical outcome and differentiate TBI from ischemia.
Cognitive and Neurology Alzheimer's Disease Center, Feinberg Medical School, Northwestern University, 320 East Superior St, Chicago, IL 60610, USA; Centro de Estudios Cerebrales, Facultad de Salud, Universidad del Valle, Sede San Fernando, Calle 4 B # 36-00, Cali, Colombia. Electronic address: dariasmo@gmail.com.
David
D
Riascos
Efraín
E
Buriticá
Eliecer
E
Jiménez
Olagide
O
Castro
Francisco
F
Guzmán
Mauricio
M
Palacios
Norberto
N
Garcia-Cairasco
Changiz
C
Geula
Martha
M
Escobar
Hernán
H
Pimienta
D000328:Adult; D000368:Aged; D034961:Antigens, Nuclear / Q000378:metabolism; D001921:Brain / Q000378:metabolism / Q000473:pathology; D001930:Brain Injuries / Q000378:metabolism* / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D056424:Decompressive Craniectomy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009419:Nerve Tissue Proteins / Q000378:metabolism; D019636:Neurodegenerative Diseases / Q000378:metabolism / Q000473:pathology; D009474:Neurons / Q000378:metabolism / Q000473:pathology; D055815:Young Adult
D034961:Antigens, Nuclear; D009419:Nerve Tissue Proteins; C506808:neuronal nuclear antigen NeuN, human
ASDH; CC; CNS; Cerebral contusion; DAI; Fluoro-Jade; H&E; Histologic correlation; ICH; ICP; IR; NeuN; Neurodegeneration; PM; TBI; TLE; acute subdural hemorrhage; central nervous system; cerebral contusion; diffuse axonal injury; hematoxylin and eosin; immunoreactivity; increased intracranial pressure; intracraneal hemorrhage; neuronal nuclear antigen; post-mortem; temporal lobe epilepsy; traumatic brain injury