Department of Neurosurgery, the First Affiliated Hospital of Chongqing Medical University, 1 Youyi Rd, Chongqing, 400016, People's Republic of China.
Department of Anesthesiology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Transl Stroke Res. 2023 Aug;14(4):530-544. doi: 10.1007/s12975-022-01052-1. Epub 2022 Jun 24.
Delayed cerebral ischemia (DCI) is the most severe complication after subarachnoid hemorrhage (SAH), and cortical spreading depolarization (CSD) is believed to play a vital role in it. However, the dynamic changes in cerebral blood flow (CBF) in response to CSD in typical SAH models have not been well investigated. Here, SAH was established in mice with endovascular perforation. Subsequently, the spontaneous CBF dropped instantly and then returned to baseline rapidly. After KCl application to the cortex, subsequent hypoperfusion waves occurred across the groups, while a lower average perfusion level was found in the SAH groups (days 1-7). Moreover, in the SAH groups, the number of CSD decreased within day 7, and the duration and spreading velocity of the CSD increased within day 3 and day 14, respectively. Next, we continuously monitored the local field potential (LFP) in the prefrontal cortex. The results showed that the decrease in the percentage of gamma oscillations lasted throughout the whole process in the SAH group. In the chronic phase after SAH, we found that the mice still had cognitive deficits but experienced no obvious tissue damage. In summary, SAH negatively affects the CBF responses to CSD and the spontaneous LFP activity and causes long-term cognitive deficits in mice. Based on these findings, in the specific phase after SAH, DCI is induced or exacerbated more easily by potential causers of CSD in clinical practice (edema, erythrocytolysis, inflammation), which may lead to neurological deterioration.
迟发性脑缺血(DCI)是蛛网膜下腔出血(SAH)后最严重的并发症,皮质扩散性抑制(CSD)被认为在其中起着至关重要的作用。然而,典型的 SAH 模型中 CSD 对脑血流(CBF)的动态变化尚未得到很好的研究。在这里,通过血管内穿孔在小鼠中建立 SAH。随后,自发的 CBF 立即下降,然后迅速恢复到基线。用 KCl 处理皮质后,各组均出现随后的低灌注波,而 SAH 组的平均灌注水平较低(第 1-7 天)。此外,在 SAH 组中,CSD 的数量在第 7 天内减少,而 CSD 的持续时间和扩展速度分别在第 3 天和第 14 天内增加。接下来,我们连续监测前额叶皮层的局部场电位(LFP)。结果表明,SAH 组中的伽马振荡百分比持续下降。在 SAH 后的慢性期,我们发现小鼠仍然存在认知缺陷,但没有明显的组织损伤。总之,SAH 对 CSD 引起的 CBF 反应和自发的 LFP 活动产生负面影响,并导致小鼠长期认知缺陷。基于这些发现,在 SAH 后的特定阶段,CSD 的潜在原因(水肿、红细胞溶解、炎症)更容易诱发或加重 DCI,从而导致神经功能恶化。