Sawauchi Satoshi, Marmarou Anthony, Beaumont Andrew, Tomita Yoshiyuki, Fukui Shinji
Division of Neurosurgery, Medical College of Virginia, Virginia Commonwealth University, Richmond, Virginia 23298-0508, USA.
J Neurotrauma. 2003 Jul;20(7):613-22. doi: 10.1089/089771503322144536.
The aim of this study was to develop a new rat model of diffuse brain injury (DBI) associated with acute subdural hemorrhage (SDH). In order to make this model more clinically relevant, we determined whether the varying hematoma volume, severity of DBI, or the presence of hypoxemia could influence the physiological consequence. SDH was made by an autologous blood injection, while DBI was induced using the impact acceleration model (mild, 450 g/1 m, severe, 450 g/2 m). Physiological parameters measured included intracranial pressure (ICP), mean arterial blood pressure (MABP), cerebral blood flow (CBF), and brain tissue water content. In the first series, 23 rats were randomized into the five following groups: Group 1, sham; Group 2, 400 (microL SDH; Group 3, SDH400 + mild DBI; Group 4, SDH400 + severe DBI; and Group 5, SDH300 + severe DBI. Results suggested that SDH300 + severe DBI (Group 5) may be the most suitable model, in which the MABP and CBF temporarily decreased during the SDH induction, but thereafter recovered to the baseline. Conversely, ICP was persistently elevated throughout the experiment. The water content was also significantly higher in both hemispheres compared to that of sham. In the second series, the animal was exposed to a hypoxemic insult (10 or 30 min) in addition to SDH300 + severe DBI (Group 6). The prolonged hypoxemia caused both a severe CBF reduction without recovery and a bilateral brain swelling, whereas the brief hypoxemia showed a gradual CBF recovery from the transient reduction and an increased water content only in the SDH side. These results suggest that these models may be potentially useful to study the combination of DBI and SDH with or without hypoxemia.
本研究的目的是建立一种与急性硬膜下血肿（SDH）相关的弥漫性脑损伤（DBI）大鼠新模型。为使该模型更符合临床实际情况，我们确定了血肿体积变化、DBI严重程度或低氧血症的存在是否会影响生理后果。通过自体血注射制造SDH，而使用撞击加速模型（轻度，450 g/1 m，重度，450 g/2 m）诱导DBI。测量的生理参数包括颅内压（ICP）、平均动脉血压（MABP）、脑血流量（CBF）和脑组织含水量。在第一组实验中，23只大鼠被随机分为以下五组：第1组，假手术组；第2组，400 μL SDH组；第3组，SDH400 + 轻度DBI组；第4组，SDH400 + 重度DBI组；第5组，SDH300 + 重度DBI组。结果表明，SDH300 + 重度DBI（第5组）可能是最合适的模型，在该模型中，MABP和CBF在SDH诱导期间暂时降低，但随后恢复到基线水平。相反，ICP在整个实验过程中持续升高。与假手术组相比，两个半球的含水量也显著更高。在第二组实验中，除了SDH300 + 重度DBI（第6组）外，动物还遭受了低氧血症损伤（10或30分钟）。长时间的低氧血症导致严重的CBF降低且未恢复，以及双侧脑肿胀，而短暂的低氧血症显示CBF从短暂降低中逐渐恢复，且仅在SDH侧含水量增加。这些结果表明，这些模型可能对研究伴有或不伴有低氧血症的DBI和SDH的组合具有潜在的用途。
