At experimental cerebral ischemia decompressive craniectomy, hypertonic saline and mannitol effect

OBJECTIVE: Cerebral ischemia can lead to serious morbidity and mortality. Strategies that will protect the cerebral tissue from ischemia damage are important. With this study of cerebral ischemia model we compared the effect of the surgical and medical treatment practiced separately or together on the anesthetized rats in the cerebral infarct area.METHOD: Thirty adult male Sprague-Dawley divided into six groups. Anesthesia was performed. Model of cerebral ischemia was provided by occlusion of the right CCA. 1ml / kg saline physiologic to Control Group (Group 1 n = 5), 1 ml / kg % 3 hypertonic saline to CCAO+hypertonic salin (HS) group 2 (Group 2, n = 5), 1 gr/kg %20 mannitol to CCAO+Mannitol (MN) group 3 (Group 3, n=5 ) treatment was given. Decompressive craniectomy (DC) performed in 12 hours following CCA occlusion was practised in group 4, 5 and 6. Only decompressive craniectomy was practised for groub 4. 1ml /kg %3 hypertonic saline was given to group CCAO+DK+HS (Group 5, n = 5).1 gr/kg %20 mannitol treatment was given to group CCAO+DK+MN (Group 6, n = 5). Tratments followed by occlusion of CCAO were performed in 1st, 12th and 24th hours. At the end of ischemia?s 24th hour rats were decapitated. Cerebral sections stained with %2 of triphenyltetrazoliumchloryd (TTC) are photographed. Percentage of infarction area to the total cross-sectional area was calculated as the percent value. p< 0.05 level was considered significant. When the results were compared in the infarct area, they were in group 1 %27.90, in group 2 %13.73, in Group 3 % 15.05, in Group 4 %10.57, in Group 5 %8.07 and in Group 6 %9.71.CONCLUSION: With this study it was determined that there wasn?t a difference between the mannitol and hypertonic saline treatments used in medical treatment of cerebral ischemia, and after addition of decompressive craniectomy to medical treatment it was observed further reduction in ischemic infarct. Combined treatment approaches that had contributed to reduce the ischemic infarct volume were found to be positive.KEY WORDS: Experimental cerebral ischemia, decompressive craniectomy, mannitol, hypertonic saline