Abstract
Symptoms are commonly more severe in pediatric traumatic brain injury (TBI) patients than in young adult TBI patients. To understand the mechanism, juvenile mice received a controlled cortical impact (CCI) injury at moderate level. Tissue lesion and cell death were measured and compared to our previous reports on brain injury in the young adult mice that received same level of impact using same injury device. Tissue lesion and cell death in the cortex was much less in the juvenile mouse brain in the first few hours after injury. However, once the injury occurred, it developed more rapidly, lasted much longer, and eventually led to exaggerated cell death and a 32.7% larger tissue lesion cavity in the cortex of juvenile mouse brain than of young adult mouse brain. Moreover, we found significant cell death in the thalamus of juvenile brains at 72 h, which was not commonly seen in the young adult mice. In summary, cell death in juvenile mice was delayed, lasted longer, and finally resulted in more severe brain injury than in the young adult mice. The results suggest that pediatric TBI patients may have a longer therapeutic window, but they also need longer intensive clinical care after injury.
Highlights
Traumatic brain injury (TBI) is a leading cause of death and disability in children[1]
The results indicated that moderate traumatic brain injury (TBI) rarely causes acute neuronal death in those remote regions in the juvenile mouse brain
Moderate cortical impact (CCI) injury causes significant brain tissue lesion and cell death in in the ipsilateral cortex of both juvenile and young adult mice, the pattern of tissue lesion and neuronal death of juvenile mice is quite different from the pattern seen in young adult mice[51]
Summary
Traumatic brain injury (TBI) is a leading cause of death and disability in children[1] This age group has the most increase each year in the rate of TBI-related emergency department (ED) visits occurring in the past 10 years. Pediatric patients are more likely to exhibit long-term symptoms during development, such as depression, anxiety, learning deficits, and attention deficits, among others[10,11,12,13,14,15] These deficits occurring after TBI resulted in poorer social, emotional, and sociosexual outcomes[16,17], and a tendency towards increased aggression, which evolves across phases of development to adulthood[18]. David Hovda’s research with rats found that it took immature animals with a mild head injury 6 to 10 times longer to recover than mature rats with the same type of injury[33] These studies showed that TBI cause dramatic injury to immature brain. The results were compared to our previous reports on brain injury in the young adult mice
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