Cerebral
contusions are one the most frequent traumatic lesions and the most
common indication for secondary surgical decompression. The purpose
of this study was to investigate the physiology of perilesional
secondary brain damage and evaluate the value of hyperbaric oxygen
therapy (HBOT) in the treatment of these lesions. Five groups of
five Sprague-Dawley rats each were submitted to dynamic cortical
deformation (DCD) induced by negative pressure applied to the
cortex. Cerebral lesions produced by DCD at the vacuum site proved
to be reproducible. The study protocol entailed the following: (1)
DCD alone, (2) DCD and HBOT, (3) DCD and post-operative hypoxia and
HBOT, (4) DCD, post-operative hypoxia and HBOT, and (5) DCD and
normobaric hyperoxia. Animals were sacrificed after 4 days.
Histological sections showed localized gross tissue loss in the
cortex at injury site, along with hemorrhage. In all cases, the
severity of secondary brain damage was assessed by counting the
number of terminal deoxynucleotidyl transferase-mediated dUTP nick
end labeling (TUNEL) and caspase 3-positive cells in successive
perilesional layers, each 0.5 mm thick. Perilesional TUNEL positive
cells suggested the involvement of apoptosis in group 1 (12.24% of
positive cells in layer 1).
These findings
were significantly enhanced by post-operative hypoxia (31.75%, p
0.001). HBOT significantly reduced the severity and extent of
secondary brain damage expressed by the number of TUNEL positive
cells in each layer and the volume of the lesion (4.7% and 9% of
TUNEL positive cells in layer 1 in groups 2 and 4 respectively, p
0.0001 and p < 0.003).
Normobaric hyperoxia also proved to be beneficial although in a
lesser extent. This study demonstrates that the vacuum model of
brain injury is a reproducible model of cerebral contusion. The
current findings also suggest that HBOT may limit the growth of
cerebral contusions and justify further experimental studies.
Kiribati, South
Tarawa
Suriname, Paramaribo
Warren, Michigan
Hungary, Budapest
Hervey Bay, Queensland
Richmond, California
Richmond, Virginia
Oakland, California
Nepal, Kathmandu
Tacoma Washington USA
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