Home > Riviste > Journal of Neurosurgical Sciences > Fascicoli precedenti > Journal of Neurosurgical Sciences 2019 December;63(6) > Journal of Neurosurgical Sciences 2019 December;63(6):714-22

ULTIMO FASCICOLO
 

JOURNAL TOOLS

eTOC
Per abbonarsi
Sottometti un articolo
Segnala alla tua biblioteca
 

ARTICLE TOOLS

Publication history
Estratti
Permessi
Per citare questo articolo

 

ORIGINAL ARTICLE   

Journal of Neurosurgical Sciences 2019 December;63(6):714-22

DOI: 10.23736/S0390-5616.16.03444-5

Copyright © 2015 EDIZIONI MINERVA MEDICA

lingua: Inglese

Neuroprotective effects of hemicraniectomy in malignant middle cerebral artery infarctions: experimental study

Ozge ALTINTAS 1 , Veysel ANTAR 2, Oguz BARAN 2, Ersin KARATAS 3, Mehmet Ozgen ALTINTAS 4, Sidika KESGIN 3, Nur BUYUKPINARBASILI 5, Abdurrahim KOCYIGIT 3, Talip ASIL 1

1 Department of Neurology, Faculty of Medicine, Bezmi Alem Vakif University, Istanbul, Turkey; 2 Department of Neurosurgery, Istanbul Training and Research Hospital, Istanbul, Turkey; 3 Department of Biochemistry, Faculty of Medicine, Bezmi Alem Vakif University, Istanbul, Turkey; 4 Department of Medical Biology, Istanbul Medipol University, Istanbul, Turkey; 5 Department of Pathology, Faculty of Medicine, Bezmi Alem Vakif University, Istanbul, Turkey


PDF


BACKGROUND: Despite optimal medical therapy the mortality rate approaches 50% in MCA infarctions. Although recent studies have been showed life-saving effect of hemicraniectomy; there are a few data available in regard to neuroprotection effect of decompressive craniectomy (DC). We induced a malignant cerebral ischemia model by intraluminal permanent middle cerebral artery occlusion (MCAo) in male rats for defining the neuroprotective effects of early DC on brain-blood barrier (BBB) molecular changes, infarct size and cerebral edema.
METHODS: A total of 48 male Spraque-Dawley rats were allocated to 4 groups; sham (N.=9), control (N.=9), experiment 1 (N.=15), experiment 2 (N.=15). DC was performed by creating a bone flap, after MCAo at 4 and 24 hours. After 28 hours of survival, all animals were sacrificed. Infarction volumes were calculated from TTC (2,3,5-triphenyl-2H-tetrazolium chloride)-stained brain sections. In all groups, cerebral edema was quantified as a change in the percentage of brain water content. Western Blot was used to analyze the expression of tight junction protein claudin-5 and occludin.
RESULTS: Brain water content was calculated 75.18±0.75% in the early DC group and 77.76±0.71% in the late DC group. No significant difference was found between experiment groups (P=0.178). In the early DC group; occludin and claudin-5 were significantly expressed at higher levels compared to late DC group (occluding, P=0.013; claudin-5, P=0.034). At early DC group (73.38±23.11 mm3) the final infarct volumes were significantly smaller than in the late DC group (377.18±39.23 mm3) (P=0.013).
CONCLUSIONS: The study results supported the neuroprotective effects of early DC in malignant MCA infarcts.


KEY WORDS: Decompressive craniectomy; Claudin-5; Middle cerebral artery infarction

inizio pagina