Abstract

BackgroundSevere brain edema is observed in a number of patients suffering from subarachnoid hemorrhage (SAH). Little is known about its pathogenesis and time-course in the first hours after SAH. This study was performed to investigate the development of brain edema and its correlation with brain perfusion after experimental SAH.MethodsMale Sprague–Dawley rats, randomly assigned to one of six groups (n = 8), were subjected to SAH using the endovascular filament model or underwent a sham operation. Animals were sacrificed 15, 30, 60, 180 or 360 minutes after SAH. Intracranial pressure (ICP), mean arterial blood pressure (MABP), cerebral perfusion pressure (CPP) and bilateral local cerebral blood flow (LCBF) were continuously measured. Brain water content (BWC) was determined by the wet/dry-weight method.ResultsAfter SAH, CPP and LCBF rapidly decreased. The decline of LCBF markedly exceeded the decline of CPP and persisted until the end of the observation period. BWC continuously increased. A significant correlation was observed between the BWC and the extent of the perfusion deficit in animals sacrificed after 180 and 360 minutes.ConclusionsThe significant correlation with the perfusion deficit after SAH suggests that the development of brain edema is related to the extent of ischemia and acute vasoconstriction in the first hours after SAH.

Highlights

  • Severe brain edema is observed in a number of patients suffering from subarachnoid hemorrhage (SAH)

  • Severe brain edema is observed in a number of patients after aneurysmal subarachnoid hemorrhage (SAH) and occurs irrespective of vasospasm-related territorial infarction

  • Physiological parameters There was no significant difference between the groups regarding pH, pCO2 and pO2 and blood glucose levels before induction of SAH, during the monitoring period or before decapitation

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Summary

Introduction

Severe brain edema is observed in a number of patients suffering from subarachnoid hemorrhage (SAH). This study was performed to investigate the development of brain edema and its correlation with brain perfusion after experimental SAH. Severe brain edema is observed in a number of patients after aneurysmal subarachnoid hemorrhage (SAH) and occurs irrespective of vasospasm-related territorial infarction. Information about the pathogenesis and the time-course of brain edema in the first hours after SAH is scarce. Experimental studies on the development of brain edema after SAH have covered the first 2 – 3 days after induction of hemorrhage. The course of brain edema in the first hours after SAH has not been investigated yet [2,3], information about a possible treatment and its timing might be derived from this data. This study was conducted to examine the development of brain swelling

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