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在蛛网膜下腔出血小鼠模型中,大血管痉挛与大脑皮质灌注不足无关。

Large Vessel Vasospasm Is Not Associated with Cerebral Cortical Hypoperfusion in a Murine Model of Subarachnoid Hemorrhage.

作者信息

Neulen Axel, Meyer Simon, Kramer Andreas, Pantel Tobias, Kosterhon Michael, Kunzelmann Svenja, Goetz Hermann, Thal Serge C

机构信息

Department of Neurosurgery, University Medical Center of the Johannes Gutenberg-University, Langenbeckstrasse 1, 55131, Mainz, Germany.

Department of Anesthesiology, University Medical Center of the Johannes Gutenberg-University, Langenbeckstrasse 1, 55131, Mainz, Germany.

出版信息

Transl Stroke Res. 2018 Jul 12;10(3):319-26. doi: 10.1007/s12975-018-0647-6.

Abstract

Clinical studies on subarachnoid hemorrhage (SAH) have shown discrepancies between large vessel vasospasm, cerebral perfusion, and clinical outcome. We set out to analyze the contribution of large vessel vasospasm to impaired cerebral perfusion and neurological impairment in a murine model of SAH. SAH was induced in C57BL/6 mice by endovascular filament perforation. Vasospasm was analyzed with microcomputed tomography, cortical perfusion by laser SPECKLE contrast imaging, and functional impairment with a quantitative neuroscore. SAH animals developed large vessel vasospasm, as shown by significantly lower vessel volumes of a 2.5-mm segment of the left middle cerebral artery (MCA) (SAH 5.6 ± 0.6 nL, sham 8.3 ± 0.5 nL, p < 0.01). Induction of SAH significantly reduced cerebral perfusion of the corresponding left MCA territory compared to values before SAH, which only recovered partly (SAH vs. sham, 15 min 35.7 ± 3.1 vs. 101.4 ± 10.2%, p < 0.01; 3 h, 85.0 ± 8.6 vs. 121.9 ± 13.4, p < 0.05; 24 h, 75.3 ± 4.6 vs. 110.6 ± 11.4%, p < 0.01; 72 h, 81.8 ± 4.8 vs. 108.5 ± 14.5%, n.s.). MCA vessel volume did not correlate significantly with MCA perfusion after 72 h (r = 0.34, p = 0.25). Perfusion correlated moderately with neuroscore (24 h: r = - 0.58, p < 0.05; 72 h: r = - 0.44, p = 0.14). There was no significant correlation between vessel volume and neuroscore after 72 h (r = - 0.21, p = 0.50). In the murine SAH model, cerebral hypoperfusion occurs independently of large vessel vasospasm. Neurological outcome is associated with cortical hypoperfusion rather than large vessel vasospasm.

摘要

蛛网膜下腔出血(SAH)的临床研究表明,大血管痉挛、脑灌注和临床结果之间存在差异。我们着手分析在SAH小鼠模型中,大血管痉挛对脑灌注受损和神经功能障碍的影响。通过血管内细丝穿孔法在C57BL/6小鼠中诱导SAH。用微型计算机断层扫描分析血管痉挛,用激光散斑对比成像分析皮质灌注,并用定量神经评分评估功能障碍。SAH动物出现大血管痉挛,如左侧大脑中动脉(MCA)2.5毫米节段的血管体积显著降低(SAH组5.6±0.6纳升,假手术组8.3±0.5纳升,p<0.01)。与SAH前的值相比,SAH的诱导显著降低了相应左侧MCA区域的脑灌注,且仅部分恢复(SAH组与假手术组,15分钟时为35.7±3.1%对101.4±10.2%,p<0.01;3小时时为85.0±8.6%对121.9±13.4%,p<0.05;24小时时为75.3±4.6%对110.6±11.4%,p<0.01;72小时时为81.8±4.8%对108.5±14.5%,无显著性差异)。72小时后,MCA血管体积与MCA灌注无显著相关性(r=0.34,p=0.25)。灌注与神经评分中度相关(24小时:r=-0.58,p<0.05;72小时:r=-0.44,p=0.14)。72小时后,血管体积与神经评分无显著相关性(r=-0.21,p=0.50)。在小鼠SAH模型中,脑灌注不足独立于大血管痉挛而发生。神经功能结局与皮质灌注不足相关,而非大血管痉挛。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bacb/6526146/703b1133e070/12975_2018_647_Fig1_HTML.jpg

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