Jadhav Vikram, Zhang John H
Department of Physiology and Pharmacology, Loma Linda University Medical Center, Loma Linda, California, USA.
Front Biosci. 2008 May 1;13:3793-7. doi: 10.2741/2968.
Neurosurgical procedures can cause inevitable brain damage resulting from the procedure itself. Unavoidable cortical and parenchymal incisions, intraoperative hemorrhage, brain lobe retraction and thermal injuries from electrocautery can cause brain injuries attributable exclusively to the neurosurgical operations and collectively referred to as surgical brain injury (SBI). This particular brain damage cannot be demarcated from the underlying brain pathology and has not been studied previously. Recently, we developed rat and mouse models to study SBI and the underlying cellular mechanisms. The animal modeling mimics a neurosurgical operation and causes commonly encountered postoperative complications such as brain edema following blood brain barrier (BBB) disruption, and neuronal cell death. Furthermore, the SBI animal model allows screening of known experimental neuroprotective agents and therapeutic agents being tried in clinical trials as possible pretreatments before neurosurgical procedures. In the present review, we elaborate on SBI and its clinical impact, the SBI animal models and their clinical relevance, and the importance of blanket neuroprotection before neurosurgical procedures.
神经外科手术会因手术本身造成不可避免的脑损伤。不可避免的皮质和实质切口、术中出血、脑叶牵拉以及电灼造成的热损伤，均可导致仅由神经外科手术引起的脑损伤，这些损伤统称为手术性脑损伤（SBI）。这种特殊的脑损伤无法与潜在的脑部病理状况区分开来，且此前尚未得到研究。最近，我们开发了大鼠和小鼠模型来研究SBI及其潜在的细胞机制。该动物模型模拟神经外科手术，并引发常见的术后并发症，如血脑屏障（BBB）破坏后的脑水肿和神经元细胞死亡。此外，SBI动物模型能够筛选已知的实验性神经保护剂以及正在临床试验中作为神经外科手术前可能的预处理药物进行试验的治疗剂。在本综述中，我们详细阐述了SBI及其临床影响、SBI动物模型及其临床相关性，以及神经外科手术前全面神经保护的重要性。
