Biological effect of shock waves on rat brain: Pathological evaluation by compact Ho: YAG laser-induced cavitational shock wave generator

To introduce shock wave as a new treatment modality for the lesions in the vicinity of brain and skull, pressure-dependent brain damages after exposure of shock wave were investigated. A novel compact Ho: YAG laser-induced cavitational shock wave generator (diameter: 15 mm, weight: 20g) was used instead of clinical lithotriptors due to their wide distribution of shock waves. In the first part, we have developed and investigated characteristics of present generator by means of high-speed photography, shadowgraphy, and pressure measurement. Generation of localized shock wave without harmful effect of laser was observed after irradiation of Ho: YAG laser in the brass tube with internal water supply. Mechanical effect of accompanying laser-induced liquid jet was mitigated after placement of latex diaphragm with acrylic water reservoir. Maximum overpressure of generated shock wave was 15 MPa before placement of diaphragm, and 5 MPa after placement of diaphragm. In the second part, shock wave-induced brain damages were investigated in 5 male Sprague-Dawley rats. While subarachnoid hemorrhage could be observed between 1 and 5 MPa, intracerebral hemorrhage, and laceration of tissue were also observed above 5 MPa. We therefore conclude that overpressure of exposing shock wave over brain surface should be managed under 1 MPa.