Plastic Surgery Research Council
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PSRC 60th Annual Meeting
Program and Abstracts

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Syndrome of the Trephined: A Novel Mouse Model Demonstrating Long-term Post-Craniectomy Neurocognitive Deficits
Brian T. Andrews, MD, Anna Lydick, BA, Scott Barbay, PhD, Randolph Nudo, PhD.
University of Kansas Medical Center, Kansas City, KS, USA.

Purpose: Hemi-craniectomy is a common surgical procedure which allows the brain to swell and herniate and treat traumatic brain injury (TBI). Long-term consequences of hemi-craniectomy calvarial defects result in neurocognitive deficits termed “syndrome of the trephined”. We hypothesize that a mouse animal model can be developed demonstrating long-term neurocognitive deficits attributed to a hemi-craniectomy defect.
Methods: C57 mice were randomized to four groups: (Group 1) control group (sham surgery), (Group 2) hemi-craniectomy only, (Group 3) hemi-craniectomy with immediate cranioplasty, (Group 4) hemi-craniectomy with TBI. Neurocognitive deficits were studied using an elevated plus maze and a beam walk test. Statistical comparison of differences amongst the four groups was performed.
Results: 40 mice were studied in four groups of ten. As expected, a beam walk test to assess motor deficit demonstrated contralateral footfault slip/step ratios were significantly more common in Group 4 (0.28), followed by Group 2 (0.18) and were only slightly more common in Group 3 (0.13) when compared to the Group 1 (0.04). There was no difference in the number of ipsilateral foot faults amongst the four groups. Time differences spent in the open vs closed portion of the elevated plus maze were assessed. Group 1 spent the most time in the closed maze (avg= 72.1 sec), followed by Group 3 (avg= 68.5 sec), Group 2 (avg= 51.9 sec). Group 4 who sustained a TBI had a slight preference for the open maze (avg= 2.3 sec)
Conclusion: Neurocognitive deficits that are attributed to a cranial defect alone are demonstrable in a mouse animal mondel. These deficits resemble those seen in the human syndrome of the trephined.


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