Beneficial Effect of Hyperbaric Oxygenation After Neonatal Germinal Matrix Hemorrhage
Background: Germinal matrix hemorrhage (GMH) is a potentially devastating neurological disease of very low birth weight premature infants. This leads to post-hemorrhagic hydrocephalus, cerebral palsy, and mental retardation. Hyperbaric oxygen (HBO) treatm
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Abstract Background: Germinal matrix hemorrhage (GMH) is a potentially devastating neurological disease of very low birth weight premature infants. This leads to post-hemorrhagic hydrocephalus, cerebral palsy, and mental retardation. Hyperbaric oxygen (HBO) treatment is a broad neuroprotectant after brain injury. This study investigated the therapeutic effect of HBO after neonatal GMH. Methods: Neonatal rats underwent stereotaxic infusion of clostridial collagenase into the right germinal matrix (anterior caudate) brain region. Cognitive function was assessed at 3 weeks, and then sensorimotor, cerebral, cardiac, and splenic growths were measured 1 week thereafter. Results: Hyperbaric oxygen (HBO) treatment markedly improved upon the mental retardation and cerebral palsy outcome measurements in rats at the juvenile developmental stage. The administration of HBO early after neonatal GMH also normalized brain atrophy, splenomegaly, and cardiac hypertrophy 1 month after injury. Conclusion: This study supports the role of hyperbaric oxygen (HBO) treatment in the early period after neonatal GMH. HBO is an effective strategy to help protect the infant’s brain from the post-hemorrhagic consequences of
T. Lekic, A. Manaenko, W. Rolland, R.P. Ostrowski, K. Virbel, and J. Tang Departments of Physiology, Loma Linda University, School of Medicine, Loma Linda, CA, USA J.H. Zhang (*) Departments of Physiology, Loma Linda University, School of Medicine, Loma Linda, CA, USA and Departments of Anesthesiology, Loma Linda University, School of Medicine, Loma Linda, CA, USA and Departments of Neurosurgery, Loma Linda University, School of Medicine, Loma Linda, CA, USA and Department of Physiology, Loma Linda University, School of Medicine, Risley Hall, Room 223, Loma Linda, CA 92354, USA e-mail: [email protected]
brain atrophy, mental retardation, and cerebral palsy. Further studies are necessary to determine the mechanistic basis of these neuroprotective effects. Keywords Hyperbaric oxygenation · Neurological deficits · Stroke, experimental
Introduction Germinal matrix hemorrhage (GMH) is a potentially devastating clinical condition with life-long consequences. This occurs when immature blood vessels rupture within the subventricular (anterior caudate) region during the first 7 days of life [1, 2]. Approximately 20–25% of very low birth weight (VLBW £ 1,500 g) premature infants will be affected, accounting for around 3.5 per 1,000 births in the United States every year [3–6]. The long-term consequences of GMH are hydrocephalus (post-hemorrhagic ventricular dilation), developmental delay, cerebral palsy, and mental retardation [4, 7]. This is an important clinical problem for which experimental studies investigating thearapeutic modalities are generally lacking [8]. Hyperbaric oxygen (HBO) treatment will induce multiple neuroprotective pathways across a wide domain of brain injury [9]. HBO has been shown in randomized controlled trials to improve cognition and overall functioning in autistic children [10], and may amelio
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