title: Selective Brain Hypothermia Mitigates Brain Damage and Improves Neurological Outcome after Post-Traumatic Decompressive Craniectomy in Mice.
abstract: Hypothermia and decompressive craniectomy (DC) have been considered as treatment for traumatic brain injury. The present study investigates whether selective brain hypothermia added to craniectomy could improve neurological outcome after brain trauma. Male CD-1 mice were assigned into the following groups: sham; DC; closed head injury (CHI); CHI followed by craniectomy (CHI+DC); and CHI+DC followed by focal hypothermia (CHI+DC+H). At 24 h post-trauma, animals were subjected to Neurological Severity Score (NSS) test and Beam Balance Score test. At the same time point, magnetic resonance imaging using a 9.4 Tesla scanner and subsequent volumetric evaluation of edema and contusion were performed. Thereafter, the animals were sacrificed and subjected to histopathological analysis. According to NSS, there was a significant impairment among all the groups subjected to trauma. Animals with both trauma and craniectomy performed significantly worse than animals with craniectomy alone. This deleterious effect disappeared when additional hypothermia was applied. BBS was significantly worse in the CHI and CHI+DC groups, but not in the CHI+DC+H group, compared to the sham animals. Edema and contusion volumes were significantly increased in CHI+DC animals, but not in the CHI+DC+H group, compared to the DC group. Histopathological analysis showed that neuronal loss and contusional blossoming could be attenuated by application of selective brain hypothermia. Selective brain cooling applied post-trauma and craniectomy improved neurological function and reduced structural damage and may be therefore an alternative to complication-burdened systemic hypothermia. Clinical studies are recommended in order to explore the potential of this treatment.
authors: 1 Department of Neurosurgery, Saarland University Medical Center and Saarland University Faculty of Medicine , Homburg/Saar, Germany .
authors: Jacek
authors: J
authors: Szczygielski
authors: 2 Department of Radiology, Saarland University Medical Center and Saarland University Faculty of Medicine , Homburg/Saar, Germany .
authors: Andreas
authors: A
authors: Müller
authors: 1 Department of Neurosurgery, Saarland University Medical Center and Saarland University Faculty of Medicine , Homburg/Saar, Germany .
authors: Angelika E
authors: AE
authors: Mautes
authors: 1 Department of Neurosurgery, Saarland University Medical Center and Saarland University Faculty of Medicine , Homburg/Saar, Germany .
authors: Christoph
authors: C
authors: Sippl
authors: 1 Department of Neurosurgery, Saarland University Medical Center and Saarland University Faculty of Medicine , Homburg/Saar, Germany .
authors: Cosmin
authors: C
authors: Glameanu
authors: 1 Department of Neurosurgery, Saarland University Medical Center and Saarland University Faculty of Medicine , Homburg/Saar, Germany .
authors: Karsten
authors: K
authors: Schwerdtfeger
authors: 1 Department of Neurosurgery, Saarland University Medical Center and Saarland University Faculty of Medicine , Homburg/Saar, Germany .
authors: Wolf-Ingo
authors: WI
authors: Steudel
authors: 1 Department of Neurosurgery, Saarland University Medical Center and Saarland University Faculty of Medicine , Homburg/Saar, Germany .
authors: Joachim
authors: J
authors: Oertel
mesh_terms: D000818:Animals; D000070624:Brain Contusion / Q000000981:diagnostic imaging / Q000628:therapy; D001929:Brain Edema / Q000000981:diagnostic imaging / Q000628:therapy*; D000070642:Brain Injuries, Traumatic / Q000000981:diagnostic imaging / Q000628:therapy*; D003131:Combined Modality Therapy; D056424:Decompressive Craniectomy / Q000379:methods*; D007036:Hypothermia, Induced / Q000379:methods*; D008279:Magnetic Resonance Imaging; D008297:Male; D051379:Mice
keywords: brain edema; closed head injury; decompressive craniectomy; focal cooling; hypothermia; mouse; traumatic brain injury