Comparing Neurological Recovery After Traumatic Brain Injury with Additive Concomitant Bone Fracture and Lung Injury

Ryan wearing a mask


College Wharton


Associate Professor of Surgery

Project Summary

In the aftermath of a car crash or an explosion, it’s rare that a victim will come out with solely a head injury. The combination of fractured bones, respiratory damage, wounds, and other concomitant injuries make cases immensely complicated for trauma providers who respond to these incidents. Consequently, it is important to evaluate how the presence of multiple injuries could affect each other, with particular consideration to how they might worsen a Traumatic Brain Injury (TBI). In previous experiments, our lab has shown separately that a concomitant tibial fracture or a concomitant lung injury will worsen neurological recovery and outcomes. These cases have not been compared to each other or combined, however, so my study will examine the additive effects of these two injuries on worsening the recovery from TBI in mouse models.

The TBI will be induced using a Controlled Cortical Impact model, during which a craniotomy exposes the brain to a metal tip that is forcefully applied with consistent velocity and tissue distortion. The Lung Insult will be done through the use of lipopolysaccharides, which induce a damaging neuroinflammatory response in the lungs. The Bone Fracture will be a fracture to the tibia bone, which is fixated immediately before the injury takes place. The study will include 7 groups: No CCI, CCI, CCI+BF, CCI+LI, CCI+BF+LI, No CCI + BF, and No CCI + LI.  

Neurological recovery after TBI in the mice will be measured via weight loss, Garcia Neurological Test (GNT) scores, Morris Water Maze (MWM) performance, and, after sacrificing the mice, wet-to-dry ratios of the brain. These measures will paint a picture of how well the mice recover from the TBI after experiencing other concomitant injuries. Ideally, the knowledge gained from this study could inform the approach to cases of human multi-trauma in military and civilian environments.

All in all, I expect this project to be a valuable learning experience for me since I will likely pursue research during my future career as a physician in the U.S. Army. This area of research in particular is relevant to my passion for military medicine, so learning the language of the field and gaining an understanding of what work needs to be done can carry with me beyond my undergraduate years. It’s important to learn in the classroom, but being able to witness the implications of those lessons through hands-on experimentation has been, and will continue to be, an invaluable part of my time in the Pascual lab.