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手术阻断皮质桥静脉引起的小鼠脑静脉梗死后脑损伤的特征。

The characteristics of brain injury following cerebral venous infarction induced by surgical interruption of the cortical bridging vein in mice.

机构信息

Department of Neurosurgery and Institute for Functional Brain Disorders, Tangdu Hospital, Fourth Military Medical University, Xi'an, PR China.

Department of Anthropotomy and Histo-Embryology, School of Basic Medicine, Fourth Military Medical University, Xi'an, PR China.

出版信息

Brain Res. 2020 Jul 15;1739:146823. doi: 10.1016/j.brainres.2020.146823. Epub 2020 Apr 6.

DOI:10.1016/j.brainres.2020.146823
PMID:32272097
Abstract

Cerebral venous infarction (CVI) caused by the injury of cortical bridging veins (CBVs), is one of the most serious complications following neurosurgical craniotomy. Different from cerebral artery infarction, this CVI pathological process is more complicated, accompanied by acute venous hypertension, brain edema, cerebral ischemia and hemorrhage in the veins bridged brain area. Therefore, a reliable and stable small animal model is particularly important for the pathological study of CVI induced by surgical CBV interruption (CBVi). A mouse model established by cutting off the right CBVs from bregma to lambda with microsurgical technique is used for the assessment of the pathological process. Adult male mice underwent craniotomy after transection of the parietal skin under anesthesia. The right CBVs were exposed by removing the right skull along the right lateral edge of the sagittal sinus (forming a 4 mm × 3 mm bone window from bregma to lambda) with a drill under the operating microscope. Following the final inspection of the cerebral veins, the CBVs (30% one, 60% two, 10% none) were sacrificed using bipolar coagulation technique. Intracranial pressure (ICP) monitoring, motor function examination, brain edema assessment and brain histopathological observation after perfusion were performed at different time points (6 h, 12 h, 24 h, and 48 h) in the postoperative mice. Cerebral hemisphere swelling, midline shift and subcortical petechial hemorrhage were found on histological sections 6 h after CBVs dissection. The change of ICP was consistent with cerebral edema and peaked at 12 h after surgery, as well as the disruption of the blood-brain barrier assessed by Evans Blue staining. Tissue necrosis, nerve cell loss and monocytes infiltration were also dynamically increased in the postoperative hemispheric cortex. Behavioral tests showed obvious somato- and forelimb-motor dysfunction, and severe somatosensory disorder on the operative mice at 12 h, which were substantially recovered at 48 h. Our study provided a novel mouse model of CVI caused by surgical CBVi that was close to clinical practice, and preliminarily confirmed its pathological process. This model might become an important tool to study the clinical pathology and the molecular mechanism of nerve injury following CVI.

摘要

脑静脉梗死(Cerebral venous infarction,CVI)由皮质桥静脉(Cortical bridging veins,CBVs)损伤引起,是神经外科开颅术后最严重的并发症之一。与脑动脉梗死不同,这种 CVI 病理过程更加复杂,伴有急性静脉高压、脑水肿、桥接脑区静脉内缺血和出血。因此,建立一种可靠且稳定的小动物模型对于研究手术 CBV 阻断(Cerebral venous interruption,CBVi)引起的 CVI 病理过程尤为重要。通过显微外科技术从额骨到鳞骨切断右侧 CBVs 建立的小鼠模型用于评估该病理过程。成年雄性小鼠在麻醉下经颅骨切开术后,切除右侧颅骨,沿矢状窦右侧边缘(在手术显微镜下从额骨到鳞骨形成一个 4mm×3mm 的骨窗)用钻头暴露右侧 CBVs。在最后检查脑静脉后,使用双极电凝技术切除 CBVs(30%1 只,60%2 只,10%无)。在术后不同时间点(6h、12h、24h 和 48h)监测颅内压(Intracranial pressure,ICP)、运动功能检查、脑水肿评估和脑组织病理学观察。在 CBVs 解剖后 6h 的组织切片上发现大脑半球肿胀、中线移位和皮质下瘀点出血。ICP 的变化与脑水肿一致,并在术后 12h 达到峰值,通过 Evans Blue 染色评估血脑屏障破坏。术后半球皮质的组织坏死、神经细胞丢失和单核细胞浸润也呈动态增加。行为学测试显示,在术后 12h 的手术小鼠中存在明显的躯体和前肢运动功能障碍,以及严重的感觉障碍,在术后 48h 显著恢复。本研究提供了一种接近临床实践的手术 CBVi 引起的 CVI 新型小鼠模型,并初步证实了其病理过程。该模型可能成为研究 CVI 后神经损伤的临床病理学和分子机制的重要工具。

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