Turkish Neurosurgery 2020 , Vol 30 , Num 4
Evaluation of the Efficacy of Sildenafil Citrate Following Severe Head Trauma in an Experimental Rat Model
1Bitlis Tatvan State Hospital, Department of Neurosurgery, Bitlis, Turkey
2Bitlis Tatvan State Hospital, Department of Pathology, Bitlis, Turkey
3Dokuz Eylul University, School of Medicine, Department of Neurosurgery, Izmir, Turkey
4Dumlupinar University, Evliya Celebi Training and Research Hospital, Department of Neurosurgery, Kutahya, Turkey
5Acibadem Mehmet Ali Aydinlar University, School of Medicine, Department of Pathology, Istanbul, Turkey
DOI : 10.5137/1019-5149.JTN.23864-18.3 AIM: To investigate the acute effects of sildenafil citrate in an experimental model of severe head trauma, and to compare it with the efficacy of mannitol, which is an osmotically active agent frequently used in clinical treatment of traumatic brain injury (TBI).

MATERIAL and METHODS: Twenty-eight Wistar-derived albino strain female rats were randomized into four groups comprising seven rats each. These groups were designated as follows: Group I: sham; Group II: TBI; Group III: TBI + mannitol (20% 1 gr/ kg, intraperitoneal); and Group IV: TBI + sildenafil citrate (10 mg/kg, intraperitoneal). Sections prepared following the tissue processing of samples obtained from the right prefrontal cortex and right hippocampal regions of the brains of sacrificed rats were histopathologically evaluated. Fractionator method via the Stereo Investigator software program (Micro Bright Field) was used to count the neurons. Pyknotic neuron count and pyknotic / total neuron count were compared between the groups.

RESULTS: In the comparison of Group II and IV, pyknotic neuron count (prefrontal; group II: 116.00 ± 30.50, group IV: 80.00 ± 19.47) and pyknotic/ total neuron count (prefrontal; group II: 0,30 ± 0.08, group IV: 0.21 ± 0.02) were significantly lower in Group IV in both regions (p<0.05). Similarly, in the comparison of Group II and III, the values in Group III were lower in both regions (p<0.05).

CONCLUSION: Sildenafil citrate decreases neuronal death in the acute phase and produces similar results with mannitol. Therefore, we believe that sildenafil citrate can be a useful adjunct or alternative agent for the clinical treatment of patients with acute TBI. Keywords : Sildenafil citrate, Mannitol, Severe head trauma, Rat

Corresponding author : Bilal KILICARSLAN, drkilicarslan@gmail.com