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实验性蛛网膜下腔出血后脑血管痉挛发展的时间进程:大鼠双重出血模型的临床和神经放射学评估

Time course in the development of cerebral vasospasm after experimental subarachnoid hemorrhage: clinical and neuroradiological assessment of the rat double hemorrhage model.

作者信息

Vatter Hartmut, Weidauer Stefan, Konczalla Juergen, Dettmann Edgar, Zimmermann Michael, Raabe Andreas, Preibisch Christine, Zanella Friedhelm E, Seifert Volker

机构信息

Department of Neurosurgery, Johann Wolfgang Goethe-University, Frankfurt, Germany.

出版信息

Neurosurgery. 2006 Jun;58(6):1190-7; discussion 1190-7. doi: 10.1227/01.NEU.0000199346.74649.66.

Abstract

OBJECTIVE

The "double hemorrhage" model in the rat is frequently used to simulate delayed cerebral vasospasm (CVS) after subarachnoid hemorrhage (SAH) in humans. However, an exact neurological and angiographic characterization of the CVS is not available for this model so far and is provided in the present investigation. Additionally, perfusion weighted imaging (PWI) at 3 tesla magnetic resonance (MR) tomography was implemented to assess the reduction in cerebral blood flow (CBF).

METHODS

In a prospective, randomized setting CVS was induced by injection of 0.2 ml autologous blood twice in the cisterna magna of 45 male Sprague-Dawley rats. The surviving animals were examined on Days 2, 3, 5, 7 and 9 and compared to a sham operated control group (n = 9). Rats were neurologically graded between 0 and 3, followed by MRI and selective digital subtraction angiography (DSA). The relative CBF was set in relation to the perfusion of the masseter muscle.

RESULTS

The neurological state was significantly worsened on Day 2 (Grade 3), 3 (Grade 3), and 5 (Grade 2) (medians). The relative CBF/muscle BF ratio (2.5 +/- 0.8 (SAH) versus 9.2 +/- 1.3 (sham) (mean +/- SEM) and the basilar artery (BA) diameter (0.15 +/- 0.02 mm (SAH) versus 0.32 +/- 0.01 mm (sham) were significantly decreased on Day 5. Correlation between relative CBF/muscle BF ratio and BA diameter was 0.70.

CONCLUSION

A valid and reproducible CVS simulation was proven by neurological score, DSA, and PWI on Day 5. Furthermore, our data demonstrate the practicability and validity of MR PWI for the monitoring of CVS in a rat SAH model.

摘要

目的

大鼠“双出血”模型常用于模拟人类蛛网膜下腔出血(SAH)后迟发性脑血管痉挛(CVS)。然而,目前该模型尚无关于CVS确切的神经学和血管造影特征描述,本研究将予以提供。此外,采用3特斯拉磁共振(MR)断层扫描的灌注加权成像(PWI)来评估脑血流量(CBF)的减少情况。

方法

在一项前瞻性随机研究中,通过向45只雄性Sprague-Dawley大鼠的枕大池内注射0.2 ml自体血两次来诱导CVS。对存活的动物在第2、3、5、7和9天进行检查,并与假手术对照组(n = 9)进行比较。对大鼠进行0至3级神经学评分,随后进行MRI和选择性数字减影血管造影(DSA)。将相对CBF与咬肌灌注相关联。

结果

在第2天(3级)、第3天(3级)和第5天(2级)(中位数)神经状态显著恶化。在第5天,相对CBF/肌肉BF比值(2.5±0.8(SAH)对9.2±1.3(假手术)(均值±标准误))和基底动脉(BA)直径(0.15±0.02 mm(SAH)对0.32±0.01 mm(假手术))显著降低。相对CBF/肌肉BF比值与BA直径之间的相关性为0.70。

结论

第5天通过神经学评分、DSA和PWI证明了一种有效且可重复的CVS模拟。此外,我们的数据证明了MR PWI在大鼠SAH模型中监测CVS的实用性和有效性。

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