Muscle Grafting as a Surgical Strategy for Restoring Blood Flow to the Mouse Brain After Stroke

Begin with an anesthetized mouse that has undergone transient middle cerebral artery occlusion.

This occlusion reduces blood supply to the right brain hemisphere, leading to ischemia.

Make an incision from the right ear to the right eye and retract the skin to expose the underlying temporalis muscle.

Using scissors, bluntly dissect the muscle.

Cut the muscle ventrally along its posterior border and gently reflect it away from the skull.

Drill a hole in the skull and carefully remove the protective membrane covering the brain.

Place the reflected muscle over the exposed ischemic brain and suture the muscle to the subcutaneous tissue of the skin flap.

Close the skin incision and allow the mouse to recover.

Over time, the temporalis muscle graft adheres to the brain surface, forming a vascular bridge.

This promotes new blood vessel formation, supports neuronal survival, and facilitates tissue repair in the ischemic region.

After 60 minutes of middle cerebral artery occlusion, randomize the mice into middle cerebral artery occlusion only or middle cerebral artery occlusion along with encephalomyosynangiosis groups.

For groups receiving encephalomyosynangiosis make a 10 to 15 millimeter skin incision with scissors, extending from one to two millimeters rostral to the right ear and one to two millimeters caudal to the right eye. Then retract the skin flaps using clamps and visually identify the temporalis muscle and the skull. Bluntly dissect the temporalis muscle away from the skull using scissors with a spreading technique.

Next, perform a two to three millimeter myotomy directed ventrally along the caudal border of the muscle to facilitate ventral reflection. Afterward, perform a craniotomy of approximately five millimeters in diameter at the skull underneath the reflected temporalis muscle using a micro drill. Next, remove the dura mater with tweezers to expose the pial surface of the brain with extreme caution to avoid accidental injury to the brain.

After suturing the incision as described in the text, place the mouse back into its cage and monitor until recovery from anesthesia. Then return the mouse to its housing facility.