title: Effect of Internal Jugular Vein Compression on Intracranial Hemorrhage in a Porcine Controlled Cortical Impact Model.
abstract: Internal jugular vein (IJV) compression has been shown to reduce axonal injury in pre-clinical traumatic brain injury (TBI) models and clinical concussion studies. However, this novel approach to prophylactically mitigating TBI through venous congestion raises concerns of increasing the propensity for hemorrhage and hemorrhagic propagation. This study aims to test the safety of IJV compression in a large animal controlled cortical impact (CCI) injury model and the resultant effects on hemorrhage. Twelve swine were randomized to placement of a bilateral IJV compression collar (CCI+collar) or control/no collar (CCI) prior to CCI injury. A histological grading of the extent of hemorrhage, both subarachnoid (SAH) and intraparenchymal (IPH), was conducted in a blinded manner by two neuropathologists. Other various measures of TBI histology were also analyzed including: β-amyloid precursor protein (β-APP) expression, presence of degenerating neurons, extent of cerebral edema, and inflammatory infiltrates. Euthanized 5 h after injury, the CCI+collar animals exhibited a significant reduction in total SAH (p = 0.024-0.026) and IPH scores (p = 0.03-0.05) compared with the CCI animals. There was no statistically significant difference in scoring for the other markers of TBI (β-APP, neuronal degeneration, cerebral edema, or inflammatory infiltration). In conclusion, IJV compression was shown to reduce hemorrhage (SAH and IPH) in the porcine CCI model when applied prior to injury. These results suggest the role of IJV compression for mitigation of not only axonal, but also hemorrhagic injury following TBI.
authors: 1 Department of Neurosurgery, NorthShore University HealthSystem , Evanston, Illinois.|2 Department of Neurosurgery, University of Florida , Gainesville, Florida.
authors: Brian
authors: B
authors: Sindelar
authors: 1 Department of Neurosurgery, NorthShore University HealthSystem , Evanston, Illinois.
authors: Julian
authors: J
authors: Bailes
authors: 1 Department of Neurosurgery, NorthShore University HealthSystem , Evanston, Illinois.
authors: Sydney
authors: S
authors: Sherman
authors: 1 Department of Neurosurgery, NorthShore University HealthSystem , Evanston, Illinois.
authors: John
authors: J
authors: Finan
authors: 1 Department of Neurosurgery, NorthShore University HealthSystem , Evanston, Illinois.
authors: James
authors: J
authors: Stone
authors: 3 Department of Pathology and Laboratory Medicine, NorthShore University HealthSystem , Evanston, Illinois.
authors: John
authors: J
authors: Lee
authors: 3 Department of Pathology and Laboratory Medicine, NorthShore University HealthSystem , Evanston, Illinois.
authors: Saman
authors: S
authors: Ahmadian
authors: 4 Department of Research Institute, NorthShore University HealthSystem , Evanston, Illinois.
authors: Ying
authors: Y
authors: Zhou
authors: 1 Department of Neurosurgery, NorthShore University HealthSystem , Evanston, Illinois.
authors: Vimal
authors: V
authors: Patel
authors: 5 Cincinnati Children's Hospital Medical Center , Cincinnati, Ohio.
authors: David
authors: D
authors: Smith
mesh_terms: D000818:Animals; D000070642:Brain Injuries, Traumatic / Q000150:complications / Q000378:metabolism / Q000473:pathology; D020202:Cerebral Hemorrhage, Traumatic / Q000209:etiology / Q000517:prevention & control*; D058128:Compression Bandages; D004195:Disease Models, Animal; D005260:Female; D007601:Jugular Veins; D011897:Random Allocation; D020206:Subarachnoid Hemorrhage, Traumatic / Q000209:etiology / Q000517:prevention & control*; D013552:Swine
keywords: CCI; SAH; TBI; animal studies; head trauma