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

Altintas O., Antar V., Baran O., Karatas E., Altintas M. O., Kesgin S., ...More

Journal of Neurosurgical Sciences, vol.63, no.6, pp.714-722, 2019 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 63 Issue: 6
  • Publication Date: 2019
  • Doi Number: 10.23736/s0390-5616.16.03444-5
  • Journal Name: Journal of Neurosurgical Sciences
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.714-722
  • Keywords: Decompressive craniectomy, Claudin-5, Middle cerebral artery infarction
  • Istanbul Medipol University Affiliated: Yes


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.