1 Department of Neurosurgery, University of Maryland School of Medicine , Baltimore, Maryland.
2 Department of Pathology, University of Maryland School of Medicine , Baltimore, Maryland.
J Neurotrauma. 2018 Sep 1;35(17):2136-2142. doi: 10.1089/neu.2017.5435. Epub 2018 Jun 5.
Primary blast traumatic brain injury (bTBI) accounts for a significant proportion of wartime trauma. Previous studies have demonstrated direct brain injury by blast waves, but the effect of the location of the blast epicenter on the skull with regard to brain injury remains poorly characterized. In order to investigate the role of the blast epicenter location, we modified a previously established rodent model of cranium-only bTBI to evaluate two specific blast foci: a rostrally focused blast centered on bregma (B-bTBI), which excluded the foramen magnum region, and a caudally focused blast centered on the occipital crest, which included the foramen magnum region (FM-bTBI). At all blast overpressures studied (668-1880 kPa), rats subjected to FM-bTBI demonstrated strikingly higher mortality, increased durations of both apnea and hypoxia, and increased severity of convexity subdural hematomas, than rats subjected to B-bTBI. Together, these data suggest a unique role for the foramen magnum region in mortality and brain injury following blast exposure, and emphasize the importance of the choice of blast focus location in experimental models of bTBI.
原发性爆炸创伤性脑损伤（bTBI）占战时创伤的很大一部分。先前的研究表明，爆炸波会直接导致脑损伤，但爆炸震中相对于颅骨的位置对脑损伤的影响仍未得到充分描述。为了研究爆炸震中位置的作用，我们修改了先前建立的仅颅骨 bTBI 啮齿动物模型，以评估两个特定的爆炸焦点：以额骨为中心的向前聚焦爆炸（B-bTBI），排除了枕骨大孔区域，以及以枕骨嵴为中心的向后聚焦爆炸（FM-bTBI），包括枕骨大孔区域。在所有研究的爆炸超压（668-1880 kPa）下，与接受 B-bTBI 的大鼠相比，接受 FM-bTBI 的大鼠死亡率显著更高，呼吸暂停和缺氧持续时间更长，凸面硬脑膜下血肿的严重程度更高。这些数据共同表明，枕骨大孔区域在爆炸暴露后死亡率和脑损伤中具有独特的作用，并强调了在 bTBI 实验模型中选择爆炸焦点位置的重要性。
