Evaluation of decompressive craniectomy in mice after severe traumatic brain injury

Yuheng Liu; Xuanhui Liu; Zhijuan Chen; Yuanzhi Wang; Jing Li; Junjie Gong; Anqi He; Mingyu Zhao; Chen Yang; Weidong Yang; Zengguang Wang

doi:10.3389/fneur.2022.898813

Evaluation of decompressive craniectomy in mice after severe traumatic brain injury

Front Neurol. 2022 Jul 26:13:898813. doi: 10.3389/fneur.2022.898813. eCollection 2022.

Authors

Yuheng Liu^{1

2}, Xuanhui Liu^{1

2}, Zhijuan Chen¹, Yuanzhi Wang^{2

3}, Jing Li^{1

2}, Junjie Gong^{1

2}, Anqi He^{1

2}, Mingyu Zhao^{1

2}, Chen Yang^{1

2}, Weidong Yang¹, Zengguang Wang^{1

2}

Affiliations

¹ Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China.
² Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin, Tianjin, China.
³ Department of Pharmacy, Tianjin Medical University General Hospital, Tianjin, China.

Abstract

Decompressive craniectomy (DC) is of great significance for relieving acute intracranial hypertension and saving lives after traumatic brain injury (TBI). In this study, a severe TBI mouse model was created using controlled cortical impact (CCI), and a surgical model of DC was established. Furthermore, a series of neurological function assessments were performed to better understand the pathophysiological changes after DC. In this study, mice were randomly allocated into three groups, namely, CCI group, CCI+DC group, and Sham group. The mice in the CCI and CCI+DC groups received CCI after opening a bone window, and after brain injury, immediately returned the bone window to simulate skull condition after a TBI. The CCI+DC group underwent DC and contused tissue removal 6 h after CCI. The mice in the CCI group underwent the same anesthesia process; however, no further treatment of the bone window and trauma was performed. The mice in the Sham group underwent anesthesia and the process of opening the skin and bone window, but not in the CCI group. Changes in Modified Neurological Severity Score, rotarod performance, Morris water maze, intracranial pressure (ICP), cerebral blood flow (CBF), brain edema, blood-brain barrier (BBB), inflammatory factors, neuronal apoptosis, and glial cell expression were evaluated. Compared with the CCI group, the CCI+DC group had significantly lower ICP, superior neurological and motor function at 24 h after injury, and less severe BBB damage after injury. Most inflammatory cytokine expressions and the number of apoptotic cells in the brain tissue of mice in the CCI+DC group were lower than in the CCI group at 3 days after injury, with markedly reduced astrocyte and microglia expression. However, the degree of brain edema in the CCI+DC group was greater than in the CCI group, and neurological and motor functions, as well as spatial cognitive and learning ability, were significantly poorer at 14 days after injury.

Keywords: animal model; controlled cortical impact (CCI); decompressive craniectomy; severe traumatic brain injury (sTBI); traumatic brain injury.