Impairment of cerebral autoregulation during the development of chronic cerebral vasospasm after subarachnoid hemorrhage in primates

Neurosurgery ◽  
1991 ◽  
pp. 41 ◽  
Author(s):  
H Takeuchi ◽  
Y Handa ◽  
H Kobayashi ◽  
H Kawano ◽  
M Hayashi
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Cerebral Vasospasm ◽  
Cerebral Autoregulation ◽  
Chronic Cerebral Vasospasm

Time course of the impairment of cerebral autoregulation during chronic cerebral vasospasm after subarachnoid hemorrhage in primates

1992 ◽  
Vol 76 (3) ◽  
pp. 493-501 ◽  
Author(s):  
Yuji Handa ◽  
Minoru Hayashi ◽  
Hiroaki Takeuchi ◽  
Tetsuya Kubota ◽  
Hidenori Kobayashi ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Cerebral Vasospasm ◽  
Cerebral Autoregulation ◽  
Time Course ◽  
Blood Clot ◽  
Autologous Blood ◽  
Conduction Time ◽  
Arterial Blood ◽  
The Right ◽  
Chronic Cerebral Vasospasm

✓ The time course of the impairment of cerebral autoregulation during chronic cerebral vasospasm after subarachnoid hemorrhage was studied in 18 monkeys. Changes in cerebral blood flow (CBF) at the regional level and central conduction times during either graded hypo- or hypertension were evaluated in these animals at three stages (3, 7, and 14 days) following the introduction of an autologous blood clot around the right middle cerebral artery (MCA). Angiograms revealed a reduction in vessel caliber (compared to the baseline level in the involved MCA) of 30% at 3 days, 50% at 7 days, and 10% at 14 days. At all stages, CBF remained constant at mean arterial blood pressures (MABP) of 60 to 160 mm Hg in the noninvolved hemisphere. In contrast, at the 3- and 7-day stages, there was an impairment of autoregulation in the involved hemisphere at MABP of 40 to 180 mm Hg. The right hemispheric CBF was significantly (p < 0.05) lower than that in the left throughout the period of investigation at MABP below 120 mm Hg, but rose to exceed the left CBF at MABP above 180 mm Hg at the 7-day stage and 160 mm Hg at the 14-day stage. The right-sided central conduction time showed significant (p < 0.05) prolongation at MABP below 60 mm Hg at the 3-day stage and 40 mm Hg at the 7-day stage. It is suggested that these results may help to develop guidelines for hemodynamic therapy for vasospasm in its various stages.

Treatment of Subarachnoid Hemorrhage with Sodium Nitroprusside and Phenylephrine

Neurosurgery ◽  
1979 ◽  
Vol 5 (5) ◽  
pp. 588-595 ◽  
Author(s):  
Charles S. Rothberg ◽  
Bryce Weir ◽  
Thomas R. Overton
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Sodium Nitroprusside ◽  
Cerebral Vasospasm ◽  
Cerebral Autoregulation ◽  
Regional Cerebral Blood Flow ◽  
Control Group ◽  
Regional Cerebral Blood ◽  
Poor Survival ◽  
Cerebrovascular Resistance ◽  
Intravenous Sodium

Abstract The effectiveness of simultaneous intravenous sodium nitroprusside and phenylephrine in improving the cerebrovascular disturbances and survival rate after induced subarachnoid hemorrhage (SAH) was studied in the cynomolgus monkey. We measured regional cerebral blood flow (rCBF) using the intra-arterial xenon-133 clearance technique. In our experimental animal model, SAH was associated with a persistent reduction in rCBF, elevation of cerebrovascular resistance (CVR), cerebral vasospasm for the duration of the study (150 minutes), and poor survival. For animals receiving the treatment regime (administered approximately 25 minutes after the induced SAH), rCBF remained low, CVR was high, and cerebral vasospasm was persistent. Survival in this group was the same as that observed for the untreated animals. Simultaneous administration of sodium nitroprusside and phenylephrine was ineffective in improving rCBF, CVR, cerebral vasospasm. or survival after SAH. In the control group (receiving only the treatment and not an intracranial insult), rCBF was below resting levels both during and after therapy, indicating impaired cerebral autoregulation.

Effect of recombinant streptokinase on the development of chronic cerebral vasospasm after subarachnoid hemorrhage in a swine model

2011 ◽  
Vol 153 (6) ◽  
pp. 1333-1338 ◽  
Author(s):  
Hongzhi Xu ◽  
Xiancheng Chen ◽  
Zhiyong Qin ◽  
Yuxiang Gu ◽  
Ping Zhou
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Cerebral Vasospasm ◽  
Swine Model ◽  
Chronic Cerebral Vasospasm

The Calmodulin Antagonist Trifluoperazine Provides Mild Prophylactic protection against Cerebral Vasospasm after Subarachnoid Hemorrhage, but No Therapeutic Value

Neurosurgery ◽  
1989 ◽  
Vol 25 (6) ◽  
pp. 917-922 ◽  
Author(s):  
John W. Peterson ◽  
Guillermo Candia ◽  
Athanasios J. Spanos ◽  
Nicholas T. Zervas
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Cerebral Vasospasm ◽  
Canine Model ◽  
Prophylactic Regimen ◽  
Smooth Muscle Contractility ◽  
Calmodulin Antagonist ◽  
Wide Range ◽  
Chronic Cerebral Vasospasm

Abstract In vitro studies of the canine basilar artery have demonstrated that calmodulin antagonism can effectively inhibit cerebral arterial smooth muscle contractility. The prophylactic and therapeutic effectiveness of a potent calmodulin antagonist. the phenothiazine compound tnfluoperazine (TFP). was investigated in vivo over a wide range of doses in the well-documented “double-subarachnoid hemorrhage” canine model of cerebral vasospasm. The compound is perhaps more well-known under its trade name. Stelazine. as a classic antipsychotic drug. The drug demonstrated no therapeutic relief of preexisting chronic cerebral vasospasm at any time during 2 days of systemic administration at any practical dose. At doses far in excess of the normally accepted therapeutic range in humans. a prophylactic regimen reduced the severity of chronic cerebral vasospasm after subarachnoid hemorrhage by approximately 35% compared to untreated dogs.

Effect of an antioxidant, ebselen, on development of chronic cerebral vasospasm after subarachnoid hemorrhage in primates

2000 ◽  
Vol 53 (4) ◽  
pp. 323-329 ◽  
Author(s):  
Yuji Handa ◽  
Masanori Kaneko ◽  
Hiroaki Takeuchi ◽  
Akira Tsuchida ◽  
Hidenori Kobayashi ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Cerebral Vasospasm ◽  
Chronic Cerebral Vasospasm

Chronic cerebral vasospasm after large subarachnoid hemorrhage in monkeys

1982 ◽  
Vol 57 (2) ◽  
pp. 224-232 ◽  
Author(s):  
Francisco Espinosa ◽  
Bryce Weir ◽  
Donald Boisvert ◽  
Thomas Overton ◽  
William Castor
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Ct Scan ◽  
Cerebral Vasospasm ◽  
Time Course ◽  
Neurological Status ◽  
Clinical Situation ◽  
Content Type ◽  
Cranial Ct ◽  
Chronic Cerebral Vasospasm ◽  
Fine Print

✓ The authors have developed a model of chronic cerebral vasospasm analogous to the clinical situation, by inducing a large subarachnoid hemorrhage (SAH) in monkeys. With this model, the size of the SAH apparent on the first computerized tomography (CT) scan was correlated with the incidence and severity of cerebral vasospasm that developed. Indices monitored for up to 21 days after SAH included cranial CT scan, cerebral blood flow, vessel caliber, and neurological status. The 18 monkeys studied for 48 hours or more were divided into two groups according to the size of the SAH on CT scan. Vasospasm was more common in the group with large SAH. In this group, on Days 0, 7, and 14, the incidence of vasospasm was significantly higher than at other times (p < 0.001, p < 0.01, and p < 0.05, respectively), and the percentage reduction in vessel caliber was significantly greater than in the group with small/medium SAH (Day 7, p < 0.02; Days 0 and 14, p < 0.05). Delayed neurological deficit developed in two monkeys with large SAH. Apathy was noted from Day 17 to Day 21 in one, and unsteadiness and drowsiness were noted on Days 4 and 5 in the other. Overall, the incidence, degree, and time course of vasospasm reflected the size of the hemorrhage.

scholarly journals Relationship Between Baroreflex and Cerebral Autoregulation in Patients With Cerebral Vasospasm After Aneurysmal Subarachnoid Hemorrhage

2022 ◽  
Vol 12 ◽  
Author(s):  
Agnieszka Uryga ◽  
Nathalie Nasr ◽  
Magdalena Kasprowicz ◽  
Karol Budohoski ◽  
Marek Sykora ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Cerebral Vasospasm ◽  
Cerebral Autoregulation ◽  
Cerebral Blood Flow Velocity ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Linear Regression Analysis ◽  
Inverse Correlation ◽  
Arterial Line ◽  
Arterial Blood ◽  
The Impact

Introduction: Common consequences following aneurysmal subarachnoid hemorrhage (aSAH) are cerebral vasospasm (CV), impaired cerebral autoregulation (CA), and disturbance in the autonomic nervous system, as indicated by lower baroreflex sensitivity (BRS). The compensatory interaction between BRS and CA has been shown in healthy volunteers and stable pathological conditions such as carotid atherosclerosis. The aim of this study was to investigate whether the inverse correlation between BRS and CA would be lost in patients after aSAH during vasospasm. A secondary objective was to analyze the time-trend of BRS after aSAH.Materials and Methods: Retrospective analysis of prospectively collected data was performed at the Neuro-Critical Care Unit of Addenbrooke's Hospital (Cambridge, UK) between June 2010 and January 2012. The cerebral blood flow velocity (CBFV) was measured in the middle cerebral artery using transcranial Doppler ultrasonography (TCD). The arterial blood pressure (ABP) was monitored invasively through an arterial line. CA was quantified by the correlation coefficient (Mxa) between slow oscillations in ABP and CBFV. BRS was calculated using the sequential cross-correlation method using the ABP signal.Results: A total of 73 patients with aSAH were included. The age [median (lower-upper quartile)] was 58 (50–67). WFNS scale was 2 (1–4) and the modified Fisher scale was 3 (1–3). In the total group, 31 patients (42%) had a CV and 42 (58%) had no CV. ABP and CBFV were higher in patients with CV during vasospasm compared to patients without CV (p = 0.001 and p &lt; 0.001). There was no significant correlation between Mxa and BRS in patients with CV, neither during nor before vasospasm. In patients without CV, a significant, although moderate correlation was found between BRS and Mxa (rS = 0.31; p = 0.040), with higher BRS being associated with worse CA. Multiple linear regression analysis showed a significant worsening of BRS after aSAH in patients with CV (Rp = −0.42; p &lt; 0.001).Conclusions: Inverse compensatory correlation between BRS and CA was lost in patients who developed CV after aSAH, both before and during vasospasm. The impact of these findings on the prognosis of aSAH should be investigated in larger studies.

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