Mass evacuation with decompressive craniotomy is considered a standard intervention for acute subdural hematoma (ASDH). However, hemispheric swelling complicates the intraoperative and postoperative management of ASDH patients, and previous studies have revealed that this approach can damage ischemic/reperfusion (I/R) injury. Few studies have focused on the cerebrovascular response following traumatic brain injury (TBI). To characterize the relative cerebral blood flow (rCBF) before and after removal of the hematoma, rats were injured by a subdural infusion of 400 μL of venous blood or paraffin oil. MRI scans were performed. Then, we monitored cortical rCBF during hematoma removal in real time using laser speckle imaging (LSCI) in ASDH rats. The CBF of arteriovenous and capillary regions were quantified and normalized to their own baseline values via a custom algorithm. In the sham group, the cortical CBF was higher post-craniotomy than pre-craniotomy. However, in the hematoma injection group, the CBF of arteries and capillaries was higher while the venous CBF was lower post-craniotomy than pre-craniotomy. The difference in the changes in vein CBF that occurred between the two groups was statistically significant. The three components of the vascular system showed heterogeneous responses to craniotomy, which may be the basis for secondary brain injury.

中文翻译：

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在大鼠模型中使用激光散斑成像在急性硬膜下血肿开颅手术期间可视化皮质脑血流动力学。

减压开颅手术被认为是急性硬膜下血肿 (ASDH) 的标准干预措施。然而，半球肿胀使 ASDH 患者的术中和术后管理复杂化，之前的研究表明，这种方法会损害缺血/再灌注 (I/R) 损伤。很少有研究关注创伤性脑损伤 (TBI) 后的脑血管反应。为了表征去除血肿之前和之后的相对脑血流量 (rCBF)，通过硬膜下输注 400 μL 静脉血或石蜡油对大鼠造成伤害。进行了 MRI 扫描。然后，我们在 ASDH 大鼠中使用激光散斑成像 (LSCI) 实时监测血肿清除过程中的皮质 rCBF。动静脉和毛细血管区域的 CBF 被量化并通过自定义算法标准化为它们自己的基线值。在假手术组中，开颅后的皮质 CBF 高于开颅前。然而，在血肿注射组中，开颅后动脉和毛细血管的 CBF 较高，而静脉 CBF 低于开颅术后。两组之间发生的静脉 CBF 变化的差异具有统计学意义。血管系统的三个组成部分对开颅手术表现出异质性反应，这可能是继发性脑损伤的基础。动脉和毛细血管的 CBF 较高，而开颅后静脉 CBF 低于开颅前。两组之间发生的静脉 CBF 变化的差异具有统计学意义。血管系统的三个组成部分对开颅手术表现出异质性反应，这可能是继发性脑损伤的基础。动脉和毛细血管的 CBF 较高，而开颅后静脉 CBF 低于开颅前。两组之间发生的静脉 CBF 变化的差异具有统计学意义。血管系统的三个组成部分对开颅手术表现出异质性反应，这可能是继发性脑损伤的基础。