Experimental Subarachnoid Hemorrhage in Rats 

1997 ◽  
Vol 87 (6) ◽  
pp. 1486-1493 ◽  
Author(s):  
Daniel J. Cole ◽  
Jeffrey C. Nary ◽  
Lowell W. Reynolds ◽  
Piyush M. Patel ◽  
John C. Drummond

Background Hemodilution with diaspirin crosslinked hemoglobin (DCLHb) ameliorates occlusive cerebral ischemia. However, subarachnoid hemoglobin has been implicated as a cause of cerebral hypoperfusion. The effect of intravenous DCLHb on cerebral perfusion and neuronal death after experimental subarachnoid hemorrhage was evaluated. Methods Rats (n = 48) were anesthetized with isoflurane and subarachnoid hemorrhage was induced by injecting 0.3 ml of autologous blood into the cistema magna. Each animal received one of the following regimens: Control, no hematocrit manipulation; DCLHb, hematocrit concentration decreased to 30% with DCLHb; or Alb, hematocrit concentration decreased to 30% with human serum albumin. The experiments had two parts, A and B. In part A, after 20 min, cerebral blood flow (CBF) was assessed with 14C-iodoantipyrine autoradiography. In part B, after 96 h, in separate animals, the number of dead neurons was determined in predetermined coronal sections by hematoxylin and eosin staining. Results Cerebral blood flow was greater for the DCLHb group than for the control group; and CBF was greater for the Alb group than the other two groups (P < 0.05). In one section, CBF was 45.5 +/- 10.9 ml x 100 g(-1) x min(-1) (mean +/- SD) for the control group, 95.3 +/- 16.6 ml x 100 g(-1) x min(-1) for the DCLHb group, and 138.1 +/- 18.7 ml x 100 g(-1) x min(-1) for the Alb group. The number of dead neurons was less in the Alb group (611 +/- 84) than in the control group (1,097 +/- 211), and was less in the DCLHb group (305 +/- 38) than in the other two groups (P < 0.05). Conclusions These data support a hypothesis that hemodilution decreases hypoperfusion and neuronal death after subarachnoid hemorrhage. The data do not support the notion that intravascular molecular hemoglobin has an adverse effect on brain injury after subarachnoid hemorrhage.

Stroke ◽  
1985 ◽  
Vol 16 (1) ◽  
pp. 58-64 ◽  
Author(s):  
R A Solomon ◽  
J L Antunes ◽  
R Y Chen ◽  
L Bland ◽  
S Chien

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
David K Kung ◽  
Nohra Chalouhi ◽  
Pascal M Jabbour ◽  
Aaron S Dumont ◽  
H. R Winn ◽  
...  

Background: Head-of-bed (HOB) elevation is usually restricted in patients with aneurysmal subarachnoid hemorrhage (SAH). This practice is believed to prevent cerebral hypoperfusion. Objective: The goal of this study is to correlate HOB changes (0 o and 90 o ) with cerebral blood flow using Trans-cranial Doppler (TCD) and thermal diffusion probe in SAH patients. Methods: Thirteen patients with SAH were prospectively enrolled in the study. Eight patients underwent placement of a thermal diffusion probe for regional CBF measurement in the same setting when placing a ventriculostomy. CBF values were measured by TCD alone (13 subjects) or concurrently with thermal diffusion probe (8 subjects) with the patients in a flat (0 o ) and upright sitting position (90 o ) at day 3, 7, and 10. Results: The average increase in blood flow velocity when changing HOB from 0 o to 90 o was 7.8% on day 3, 0.1% on day 7, and 13.1% on day 10. The middle cerebral artery had the least changes in velocity compared to the anterior cerebral and the posterior cerebral arteries. The average regional CBF measurement was 22.7 +/- 10.3 ml/100g/min in the supine position and 23.6 +/- 9.1 mg/100g/min in the sitting position. The changes were not statistically significant. No change in clinical exam was appreciated. None of the patients developed clinical cerebral vasospasm. Conclusion: Changing HOB position in the setting of SAH did not significantly affect either cerebral blood flow velocity or regional blood flow. This data suggests that early mobilization should be considered given the detrimental effects of prolonged bed rest.


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