Decompressive craniectomy has been widely used in patients with
head trauma. The randomized clinical trial on an early
decompression (DECRA) demonstrated that
craniectomy did not improve the neurological outcome, in contrast to previous animal experiments. The goal of our study was to analyze the effect of
decompressive craniectomy in a murine model of
head injury. Male mice were assigned into the following groups:
sham,
decompressive craniectomy,
closed head injury (CHI), and CHI followed by
craniectomy. At 24 h post-
trauma, animals underwent the Neurological Severity Score test (NSS) and Beam Balance Score test (BBS). At the same time point, magnetic resonance imaging was performed, and volume of
edema and
contusion was assessed, followed by histopathological analysis. According to NSS, animals undergoing both
trauma and
craniectomy presented the most severe neurological impairment. Also, balancing time was reduced in this group compared with
sham animals. Both
edema and
contusion volume were increased in the
trauma and
craniectomy group compared with
sham animals. Histopathological analysis showed that all animals that underwent
trauma presented substantial neuronal loss. In animals treated with
craniectomy after
trauma, a massive increase of
edema with hemorrhagic transformation of
contusion was documented.
Decompressive craniectomy applied after
closed head injury in mice leads to additional structural and functional impairment. The
surgical decompression via
craniectomy promotes
brain edema formation and contusional blossoming in our model. This additive effect of combined mechanical and surgical
trauma may explain the results of the DECRA trial and should be explored further in experiments.