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Neurocirugía
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Neurocirugía
Article . 2009 . Peer-reviewed
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Modelos experimentales de traumatismo craneoencefálico

Authors: Prieto, R.; Gutiérrez-González, R.; Pascual, J.M.; Roda, J.M.; Cerdán, S.; Matias-Guiu, J.; Barcia, J.A.;

Modelos experimentales de traumatismo craneoencefálico

Abstract

[ES]: Objetivo. El objetivo de este trabajo es proporcionar una revisión de los diversos modelos experimentales de traumatismo craneoencefálico (TCE) que se han desarrollado para la investigación del daño cerebral traumático tanto en condiciones in vivo como in vitro, así como detallar los principales conocimientos fisiopatológicos obtenidos a partir de su aplicación. Se expone de forma sintética tanto el tipo de lesión cerebral traumática que cada modelo reproduce como los detalles técnicos necesarios para su utilización por investigadores en el campo del trauma cerebral. Desarrollo. El pronóstico de los pacientes que han sufrido un TCE ha mejorado gracias a las medidas iniciales de estabilización hemodinámica y control de la vía aérea, pero no existe todavía ningún tratamiento específico y eficaz para detener o limitar las lesiones cerebrales causadas por el traumatismo, exceptuando las medidas de control de la presión arterial y la presión intracraneal. Entender la fisiopatología del TCE es el paso básico y fundamental para desarrollar posibles abordajes terapéuticos con aplicación clínica. El daño cerebral traumático en humanos es una patología heterogénea y muy compleja. Por ello, cada modelo experimental se ha desarrollado con el objetivo de reproducir un tipo concreto de las diferentes lesiones cerebrales observadas en pacientes tras un TCE. El uso de estos modelos ha permitido ampliar el conocimiento sobre la fisiopatología del daño cerebral traumático, incluyendo las alteraciones inducidas a nivel celular y molecular. Conclusión. Los modelos experimentales suponen actualmente la mejor herramienta para el estudio de los mecanismos subyacentes a las lesiones cerebrales traumáticas, pero su simplicidad y por lo tanto su incapacidad de reproducir exactamente el daño heterogéneo observado en la práctica clínica puede ser uno de los motivos que explique la discrepancia en la respuesta terapéutica entre los estudios experimentales y clínicos.

[EN]: Aim. To provide a summary of the different experimental models of traumatic brain injury (TBI) designed under both in vivo and in vitro conditions. A comprehensible review of the specific types of brain lesions induced, as well as the technical details to reproduce each model at the laboratory is given. Development. Outcome of patients suffering from a TBI has significantly improved with the rapid application of vital supporting measures in addition to a strict control of blood and intracranial pressure at the intensive care units. However no specific treatment for post-traumatic brain lesions has proven as efficacious in the clinical settings. A deeper knowlegde of the physiopathological events associated with TBI is necessary for the development of new specific therapies. Due to the heterogeneity of the human TBI, each experimental model has been designed to reproduce a different type of brain lesion. Experimental TBI models allow the study of the dynamic evolution of brain injuries under controlled conditions. Usefulness of experimental models is limited by their reliability and reproducibility among different researchers. Small rodents have been the preferred animals to reproduce TBI injuries, mainly due to the similar cerebral physiology shared by these animals and the human beings. Conclusion. The use of experimental models of TBI is the most appropiate tool to study the mechanisms underlying this type of injury. However their simplicity precludes an exact reproduction of the heterogeneous cerebral damage observed in clinical settings. This could be the main reason for the discrepancies observed in the therapeutic effects of treatments between experimental and clinical studies.

20 pages, 6 figures, 1 table.

Peer reviewed

Keywords

Contusión cerebral, Modelos experimentales, TCE, Tce, Edema cerebral, Traumatic brain injury, TBI, Tbi, Brain edema, Daño cerebral traumático, Cerebral contusion, Experimental models

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selected citations
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This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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