Artikel
Cerebral malperfusion occurs independent of large vessel vasospasm in a murine model of subarachnoid hemorrhage
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Veröffentlicht: | 18. Juni 2018 |
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Gliederung
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Objective: Cerebral vasospasm and cerebral malperfusion are thought to be major determinants for an unfavorable outcome after subarachnoid hemorrhage (SAH). However, clinical studies showed discrepancies between large vessel vasospasm and clinical outcome. In the present study, we therefore set out to analyze the contribution of large vessel vasospasm to impaired cerebral perfusion and neurological impairment in a murine model of SAH.
Methods: SAH was induced in C57BL/6 mice by endovascular filament perforation. Vasospasm of the left middle cerebral artery (MCA) was analyzed 72 hours after SAH with micro computed tomography. Cerebral cortical perfusion of the corresponding MCA territory was determined before and 15 minutes, 3 hours, 24 hours, and 72 hours after SAH using laser SPECKLE contrast imaging. A quantitative neuroscore was used to assess functional impairment.
Results: SAH animals developed large vessel vasospasm shown by significantly lower vessel volumes of a 2.5 mm segment of the left MCA in SAH animals compared to sham (SAH: 5.6±0.6 nl; sham: 8.3±0.5 nl, p<0.01), Induction of SAH significantly reduced cerebral perfusion of the left MCA territory to 35.7±3.1% compared to the values before SAH (p<0.001). Perfusion recovered only partly (3h: 85.0±8.6% (p<0.05), 24h: 75.3±4.6% (p<0.01), 72h: 81.8±4.8%). There was no clear correlation between vasospasm of the MCA and perfusion after 72 hours (r=0.34, p=0.25). Perfusion correlated moderately with the neuroscores after 24 (r=-0.58, p<0.05) and 72 hours (r=-0.44, p=0.14). There was no clear correlation between vessel volumes and vessel diameters and neuroscores after 72 hours (r=-0.21, p=0.50).
Conclusion: In the murine SAH model, cerebral malperfusion occurs independent of large vessel vasospasm. Neurological outcome is associated with cerebral malperfusion rather than large vessel vasospasm.