The effect of intracarotid mannitol infusion on brain edema after severe head trauma in experimental rat model

Objective: The aim of this study is to investigate the effects of intravenous and intracarotid mannitol infusion on brain edema in rats with severe head trauma.Materials and methods: In this study 24 Wistar Albino type female rats divided into four groups. The groups were like this: Group 1: Sham (rats not induced to severe head trauma), Group 2: rats induced to severe head trauma, no treatment has given, Group 3: rats induced to severe head trauma, intravenous %20 mannitol 1 gr/kg has given as treatment, Group 4: rats induced to severe head trauma, intracarotid %20 mannitol 1 gr/kg has given as treatment. One hour after severe head trauma, 1 gr/kg mannitol was administered to group 3 and 4. Four hours after severe head trauma the rats were sacrified. MDA and catalase levels were measured in brain tissue by biochemical methods. Tissue samples were gone to routine histologic follow-up, than cell count was measured in prefrontal cortex sections.Results: Neuron count was significantly decreased in trauma group compared to sham group. With intravenous and intracarotid administration of mannitol, neuron count was near sham group. In histopathological analysis there was no significant difference between administration methods. As the histopathological results were not istatistically significant; neuron counts from right hemisphere were better than intravenous mannitol group by administration from right carotid artery. MDA levels measured in brain tissue by biochemical method were significantly increased in trauma group compared to sham group. MDA levels were significantly decreased by administration of intravenous mannitol after traumatic brain injury. By intravenous mannitol administration after severe head trauma, MDA levels were significantly decreased. MDA level were increased in intracarotid mannitol group contrary to expected. Catalase levels were decreased as it was expected to increased in trauma group compared to sham group. Catalase levels were increased in intravenous and intracarotid mannitol groups as compared to trauma group. Catalase levels were higher in intracarotid mannitol group as compared to intravenous mannitol group.Conclusion : As a result, when we evaluate right hemisphere neuron counts, intracarotid mannitol administration after severe head trauma gives better results than intravenous administration also it is not istatistically significant. MDA measurement results are a bit better in favor of intravenous administration, this can explained by increasing oxidative stres in local administration of mannitol. Catalase measurement results can be interpreted by unexplained role of catalase in head trauma yet as in literature.Key words: Severe head injury, brain edema, mannitol