Lee Jin-Yul, Sagher Oren, Keep Richard, Hua Ya, Xi Guohua
Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan 48109-2200, USA.
Neurosurgery. 2009 Aug;65(2):331-43; discussion 343. doi: 10.1227/01.NEU.0000345649.78556.26.
To investigate acute pathophysiological changes after subarachnoid hemorrhage (SAH) in rats and compare endovascular perforation and double blood injection models for studies of early brain injury after SAH.
Rat SAH was induced by endovascular perforation of the internal carotid artery (n = 41) or double injection of autologous blood into the cisterna magna (n = 23). Effects of SAH on arterial blood pressure, intracranial pressure, cerebral artery dimensions, and cerebral blood flow were measured. Neuronal death was assessed 24 hours after SAH.
SAH was more severe in the endovascular perforation model (4-fold greater hemoglobin content on the basal brain surface), and mortality was greater (47%) than in the blood injection model (0%). Intracranial pressure increases were faster and greater in the perforation model. Correspondingly, cerebral blood flow reductions were greater after perforation than in the blood injection model, particularly in middle cerebral artery-supplied regions (32 +/- 16 versus 65 +/- 18 mL/100 g/min, P < 0.01). Diffuse neuronal death occurred in all rats in the perforation model but more seldom after blood injection. Anterior cerebral artery diameter and cross sectional area were significantly decreased on day 1 after SAH induction (52 +/- 21% and 22 +/- 16% of control values; P < 0.001) in the perforation model but not after blood injection.
The perforation model produced more severe pathophysiological changes than the double blood injection, and it mimics human SAH in having an injured blood vessel and direct hemorrhagic brain lesion under arterial blood pressure. Therefore, endovascular perforation seems more suitable for study of acute SAH sequelae. However, further model refinement is required to reduce the high mortality rate.
研究大鼠蛛网膜下腔出血(SAH)后的急性病理生理变化,并比较血管内穿刺和二次注血模型在SAH后早期脑损伤研究中的应用。
通过颈内动脉血管内穿刺(n = 41)或向小脑延髓池二次注入自体血(n = 23)诱导大鼠SAH。测量SAH对动脉血压、颅内压、脑动脉尺寸和脑血流量的影响。在SAH后24小时评估神经元死亡情况。
血管内穿刺模型中的SAH更严重(基底脑表面血红蛋白含量高4倍),死亡率也高于注血模型(47%比0%)。穿刺模型中颅内压升高更快且更高。相应地,穿刺后脑血流量减少比注血模型更明显,特别是在大脑中动脉供血区域(32±16比65±18 mL/100 g/min,P < 0.01)。穿刺模型中所有大鼠均出现弥漫性神经元死亡,而注血后较少见。SAH诱导后第1天,穿刺模型中大脑前动脉直径和横截面积显著减小(分别为对照值的52±21%和22±16%;P < 0.001),注血模型则未出现此情况。
与二次注血模型相比,穿刺模型产生的病理生理变化更严重,且在动脉血压作用下有受损血管和直接出血性脑损伤,类似于人类SAH。因此,血管内穿刺似乎更适合研究急性SAH后遗症。然而,需要进一步优化模型以降低高死亡率。