Unravelling Secondary Brain Injury: Insights from a Human-Sized Porcine Model of Acute Subdural Haematoma
Traumatic brain injury (TBI) remains one of the leading causes of death. Because of the individual nature of the trauma (brain, circumstances and forces), humans experience individual TBIs. This makes it difficult to generalise therapies. Clinical management issues such as whether intracranial press...
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2024-12-01
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| author | Thomas Kapapa Vanida Wernheimer Andrea Hoffmann Tamara Merz Fabia Zink Eva-Maria Wolfschmitt Oscar McCook Josef Vogt Martin Wepler David Alexander Christian Messerer Claire Hartmann Angelika Scheuerle René Mathieu Simon Mayer Michael Gröger Nicole Denoix Enrico Clazia Peter Radermacher Stefan Röhrer Thomas Datzmann |
| author_facet | Thomas Kapapa Vanida Wernheimer Andrea Hoffmann Tamara Merz Fabia Zink Eva-Maria Wolfschmitt Oscar McCook Josef Vogt Martin Wepler David Alexander Christian Messerer Claire Hartmann Angelika Scheuerle René Mathieu Simon Mayer Michael Gröger Nicole Denoix Enrico Clazia Peter Radermacher Stefan Röhrer Thomas Datzmann |
| author_sort | Thomas Kapapa |
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| description | Traumatic brain injury (TBI) remains one of the leading causes of death. Because of the individual nature of the trauma (brain, circumstances and forces), humans experience individual TBIs. This makes it difficult to generalise therapies. Clinical management issues such as whether intracranial pressure (ICP), cerebral perfusion pressure (CPP) or decompressive craniectomy improve patient outcome remain partly unanswered. Experimental drug approaches for the treatment of secondary brain injury (SBI) have not found clinical application. The complex, cellular and molecular pathways of SBI remain incompletely understood, and there are insufficient experimental (animal) models that reflect the pathophysiology of human TBI to develop translational therapeutic approaches. Therefore, we investigated different injury patterns after acute subdural hematoma (ASDH) as TBI in a post-hoc approach to assess the impact on SBI in a long-term, human-sized porcine TBI animal model. Post-mortem brain tissue analysis, after ASDH, bilateral ICP, CPP, cerebral oxygenation and temperature monitoring, and biomarker analysis were performed. Extracerebral, intraparenchymal–extraventricular and intraventricular blood, combined with brainstem and basal ganglia injury, influenced the experiment and its outcome. Basal ganglia injury affects the duration of the experiment. Recognition of these different injury patterns is important for translational interpretation of results in this animal model of SBI after TBI. |
| format | Article |
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| issn | 2073-4409 |
| language | English |
| publishDate | 2024-12-01 |
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| series | Cells |
| spelling | doaj-art-6cd195311d3b44dc85dadc74dca901502025-08-20T02:36:05ZengMDPI AGCells2073-44092024-12-011411710.3390/cells14010017Unravelling Secondary Brain Injury: Insights from a Human-Sized Porcine Model of Acute Subdural HaematomaThomas Kapapa0Vanida Wernheimer1Andrea Hoffmann2Tamara Merz3Fabia Zink4Eva-Maria Wolfschmitt5Oscar McCook6Josef Vogt7Martin Wepler8David Alexander Christian Messerer9Claire Hartmann10Angelika Scheuerle11René Mathieu12Simon Mayer13Michael Gröger14Nicole Denoix15Enrico Clazia16Peter Radermacher17Stefan Röhrer18Thomas Datzmann19Department of Neurosurgery, University Hospital Ulm, Albert-Einstein-Allee 23, 89081 Ulm, GermanyDepartment of Neurosurgery, University Hospital Ulm, Albert-Einstein-Allee 23, 89081 Ulm, GermanyInstitute of Anaesthesiologic Pathophysiology and Process Development, University Hospital Ulm, Helmholtzstrasse 8/1, 89081 Ulm, GermanyInstitute of Anaesthesiologic Pathophysiology and Process Development, University Hospital Ulm, Helmholtzstrasse 8/1, 89081 Ulm, GermanyInstitute of Anaesthesiologic Pathophysiology and Process Development, University Hospital Ulm, Helmholtzstrasse 8/1, 89081 Ulm, GermanyInstitute of Anaesthesiologic Pathophysiology and Process Development, University Hospital Ulm, Helmholtzstrasse 8/1, 89081 Ulm, GermanyInstitute of Anaesthesiologic Pathophysiology and Process Development, University Hospital Ulm, Helmholtzstrasse 8/1, 89081 Ulm, GermanyInstitute of Anaesthesiologic Pathophysiology and Process Development, University Hospital Ulm, Helmholtzstrasse 8/1, 89081 Ulm, GermanyDepartment of Anaesthesiology, University Hospital Ulm, Albert-Einstein-Allee 23, 89081 Ulm, GermanyInstitute of Transfusion Medicine, University Hospital Ulm, Helmholtzstrasse 10, 89081 Ulm, GermanyDepartment of Anaesthesiology, University Hospital Ulm, Albert-Einstein-Allee 23, 89081 Ulm, GermanySection Neuropathology, University Hospital Ulm, Albert-Einstein-Allee 23, 89081 Ulm, GermanyDepartment of Neurosurgery, Military Hospital Ulm, Oberer Eselsberg 40, 89081 Ulm, GermanyDepartment of Neurosurgery, Military Hospital Ulm, Oberer Eselsberg 40, 89081 Ulm, GermanyInstitute of Anaesthesiologic Pathophysiology and Process Development, University Hospital Ulm, Helmholtzstrasse 8/1, 89081 Ulm, GermanyInstitute of Anaesthesiologic Pathophysiology and Process Development, University Hospital Ulm, Helmholtzstrasse 8/1, 89081 Ulm, GermanyInstitute of Anaesthesiologic Pathophysiology and Process Development, University Hospital Ulm, Helmholtzstrasse 8/1, 89081 Ulm, GermanyInstitute of Anaesthesiologic Pathophysiology and Process Development, University Hospital Ulm, Helmholtzstrasse 8/1, 89081 Ulm, GermanyDepartment of Neurosurgery, Ostalb-Hospital Aalen, Im Kälblesrain 1, 73430 Aalen, GermanyInstitute of Anaesthesiologic Pathophysiology and Process Development, University Hospital Ulm, Helmholtzstrasse 8/1, 89081 Ulm, GermanyTraumatic brain injury (TBI) remains one of the leading causes of death. Because of the individual nature of the trauma (brain, circumstances and forces), humans experience individual TBIs. This makes it difficult to generalise therapies. Clinical management issues such as whether intracranial pressure (ICP), cerebral perfusion pressure (CPP) or decompressive craniectomy improve patient outcome remain partly unanswered. Experimental drug approaches for the treatment of secondary brain injury (SBI) have not found clinical application. The complex, cellular and molecular pathways of SBI remain incompletely understood, and there are insufficient experimental (animal) models that reflect the pathophysiology of human TBI to develop translational therapeutic approaches. Therefore, we investigated different injury patterns after acute subdural hematoma (ASDH) as TBI in a post-hoc approach to assess the impact on SBI in a long-term, human-sized porcine TBI animal model. Post-mortem brain tissue analysis, after ASDH, bilateral ICP, CPP, cerebral oxygenation and temperature monitoring, and biomarker analysis were performed. Extracerebral, intraparenchymal–extraventricular and intraventricular blood, combined with brainstem and basal ganglia injury, influenced the experiment and its outcome. Basal ganglia injury affects the duration of the experiment. Recognition of these different injury patterns is important for translational interpretation of results in this animal model of SBI after TBI.https://www.mdpi.com/2073-4409/14/1/17secondary brain injuryanimal modelacute subdural haematomatraumatic brain injurymanagementguidelines |
| spellingShingle | Thomas Kapapa Vanida Wernheimer Andrea Hoffmann Tamara Merz Fabia Zink Eva-Maria Wolfschmitt Oscar McCook Josef Vogt Martin Wepler David Alexander Christian Messerer Claire Hartmann Angelika Scheuerle René Mathieu Simon Mayer Michael Gröger Nicole Denoix Enrico Clazia Peter Radermacher Stefan Röhrer Thomas Datzmann Unravelling Secondary Brain Injury: Insights from a Human-Sized Porcine Model of Acute Subdural Haematoma Cells secondary brain injury animal model acute subdural haematoma traumatic brain injury management guidelines |
| title | Unravelling Secondary Brain Injury: Insights from a Human-Sized Porcine Model of Acute Subdural Haematoma |
| title_full | Unravelling Secondary Brain Injury: Insights from a Human-Sized Porcine Model of Acute Subdural Haematoma |
| title_fullStr | Unravelling Secondary Brain Injury: Insights from a Human-Sized Porcine Model of Acute Subdural Haematoma |
| title_full_unstemmed | Unravelling Secondary Brain Injury: Insights from a Human-Sized Porcine Model of Acute Subdural Haematoma |
| title_short | Unravelling Secondary Brain Injury: Insights from a Human-Sized Porcine Model of Acute Subdural Haematoma |
| title_sort | unravelling secondary brain injury insights from a human sized porcine model of acute subdural haematoma |
| topic | secondary brain injury animal model acute subdural haematoma traumatic brain injury management guidelines |
| url | https://www.mdpi.com/2073-4409/14/1/17 |
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